Irvin G L, Deriso G T
Department of Surgery, University of Miami School of Medicine, Florida 33101.
Am J Surg. 1994 Nov;168(5):466-8. doi: 10.1016/s0002-9610(05)80101-1.
The clinical usefulness of intraoperative parathyroid hormone (PTH) monitoring has been shown using an immunoradiometric assay (IRMA) with several significant limitations. PTH measurement by immunochemiluminometric assay (ICMA) is a nonradioisotopic technique that is more practical for use during parathyroidectomy.
Plasma from a 15-second microcentrifugation was mixed with 2 antibodies, incubated at 45 degrees C, shaken at 400 rpm for 7 minutes, washed and counted for 2 seconds on a portable luminometer; PTH level was reported in 10 minutes.
Sixteen patients had multiple samples taken during parathyroidectomy. PTH levels measured 5 minutes after excision of a suspected abnormal gland were compared with preoperative or preexicision samples and either confirmed complete excision or indicated the need for more exploration in each patient. Correlation of 88 ICMA samples with standard 24-hour IRMA controls was excellent (r = 0.9218, P < 0.0001). The sensitivity of the test in predicting postoperative calcium levels was 94%.
This new assay can serve as a very practical adjunct for the parathyroid surgeon.
术中甲状旁腺激素（PTH）监测的临床实用性已通过免疫放射分析（IRMA）得到证实，但存在一些显著局限性。免疫化学发光分析（ICMA）检测PTH是一种非放射性技术，在甲状旁腺切除术中使用更为实用。
将15秒微量离心所得血浆与2种抗体混合，在45℃孵育，以400转/分钟振荡7分钟，洗涤后在便携式发光计上计数2秒；10分钟内报告PTH水平。
16例患者在甲状旁腺切除术中采集了多个样本。将疑似异常腺体切除后5分钟测得的PTH水平与术前或切除前样本进行比较，以确认每位患者是否已完全切除或是否需要进一步探查。88份ICMA样本与标准24小时IRMA对照的相关性良好（r = 0.9218，P < 0.0001）。该检测预测术后血钙水平的敏感性为94%。
这种新检测方法可为甲状旁腺外科医生提供非常实用的辅助手段。
