Kawagishi T, Nishizawa Y, Emoto M, Kawasaki K, Shoji S, Inaba M, Miki T, Morita A, Tabata T, Inoue T
Second Department of Internal Medicine, Osaka City University Medical School, Japan.
Miner Electrolyte Metab. 1995;21(1-3):104-8.
High-resolution, real-time ultrasonography was performed in 245 uremic patients on maintenance hemodialysis and the growth of the enlarged parathyroid glands was compared with the clinical and biochemical signs during follow-up periods of 12 months. The total volume of the parathyroid glands was significantly correlated with the serum C-terminal parathyroid hormone (C-PTH; r = 0.379, p = 0.0001) and calcium levels (r = 0.252, p = 0.0224). After 12 months, the total volume of the enlarged parathyroid glands and serum C-PTH or calcium levels were correlated more closely than in the initial study (r = 0.615, p = 0.0001, and r = 0.489, p = 0.0002, respectively). Both the serum C-PTH levels and the total volume of the enlarged parathyroid glands increased significantly (p = 0.0001), while the ratio between the serum C-PTH levels and the volume of the parathyroid glands decreased significantly (p = 0.0001). There was no difference in the clinical and biochemical signs except for the serum aluminum levels between the patients with and without an increased gland volume. These results suggest that the growth of parathyroid glands may progress more rapidly than the increase in the serum PTH levels, independent of the serum calcium levels, in uremic patients on maintenance hemodialysis.
对245例维持性血液透析的尿毒症患者进行了高分辨率实时超声检查，并在12个月的随访期内，将增大的甲状旁腺的生长情况与临床和生化指标进行了比较。甲状旁腺的总体积与血清甲状旁腺激素C端（C-PTH；r = 0.379，p = 0.0001）和钙水平（r = 0.252，p = 0.0224）显著相关。12个月后，增大的甲状旁腺总体积与血清C-PTH或钙水平的相关性比初始研究中更紧密（分别为r = 0.615，p = 0.0001和r = 0.489，p = 0.0002）。血清C-PTH水平和增大的甲状旁腺总体积均显著增加（p = 0.0001），而血清C-PTH水平与甲状旁腺体积之比则显著降低（p = 0.0001）。甲状旁腺体积增加和未增加的患者之间，除血清铝水平外，临床和生化指标无差异。这些结果表明，在维持性血液透析的尿毒症患者中，甲状旁腺的生长可能比血清PTH水平的升高进展更快，且与血清钙水平无关。
