Martínez M E, Carcamo Valor P, Hidalgo Togores L, Mateos Antón F, Martínez-Piñeiro J A
Departamento de Laboratorio, Hospital La Paz, Universidad Autónoma, Madrid, España.
Arch Esp Urol. 1995 Jun;48(5):489-95.
To carry out a comparative biochemical study of primary hyperparathyroidism, the different types of hypercalciuria and a healthy population.
Fourteen patients with primary hyperparathyroidism and 103 patients with idiopathic hypercalciuria were studied under conditions of restricted calcium intake and following a calcium load; the results were compared to those of 18 healthy controls.
The patients with hyperparathyroidism showed high parathormone concentrations. Sixty-nine patients with idiopathic hypercalciuria had normal parathormone levels and were considered suffering from absorptive hypercalciuria. Those patients with high urinary calcium excretion under restricted calcium intake and normal urinary phosphate threshold were considered as being absorptive hypercalciuria type I, those with normal urinary calcium as absorptive hypercalciuria type II, and those with low urinary phosphate threshold constituted a renal phosphate leakage group. Thirty-four patients had normal serum calcium, elevated parathormone, hypophosphatemia and high calcium excretion under all dietary conditions, and were considered undergoing renal hypercalciuria. Patients with renal hypercalciuria had increased urine hydroxyproline and low serum calcium compared with the controls after an oral calcium load. This biochemical behaviour is compatible with secondary hyperparathyroidism caused by renal calcium leakage.
In summary, the biochemical parameters: parathormone, urinary phosphate threshold and urinary calcium excretion, measured in fasting conditions, allowed classification of patients with idiopathic hypercalciuria.
对原发性甲状旁腺功能亢进症、不同类型的高钙尿症和健康人群进行比较生化研究。
对14例原发性甲状旁腺功能亢进症患者和103例特发性高钙尿症患者在钙摄入受限的条件下及进行钙负荷后进行研究；将结果与18例健康对照者的结果进行比较。
甲状旁腺功能亢进症患者甲状旁腺激素浓度较高。69例特发性高钙尿症患者甲状旁腺激素水平正常，被认为患有吸收性高钙尿症。在钙摄入受限情况下尿钙排泄高且尿磷阈值正常的患者被视为I型吸收性高钙尿症，尿钙正常的患者为II型吸收性高钙尿症，尿磷阈值低的患者构成肾性磷漏组。34例患者血清钙正常，甲状旁腺激素升高，低磷血症，在所有饮食条件下钙排泄均高，被认为患有肾性高钙尿症。口服钙负荷后，肾性高钙尿症患者与对照组相比尿羟脯氨酸增加，血清钙降低。这种生化表现与肾钙漏引起的继发性甲状旁腺功能亢进相符。
总之，在空腹条件下测量的生化参数：甲状旁腺激素、尿磷阈值和尿钙排泄，可对特发性高钙尿症患者进行分类。
