Sortino N, Puccini M, Iacconi P, Pierallini S, Miccoli P
Istituto di Clinica Chirurgica, Università degli Studi di Pisa.
Minerva Chir. 1994 Apr;49(4):303-7.
In a patient submitted to thyroidectomy a transitory hypocalcemia can develop, the frequency of which is very variable in reference with on international literature. Several hypotheses have been enunciated to explain the phenomenon. This study would contribute to suggest its etiology and to quantify its entity. For this purpose we selected a series of patients among those operated from September, 1989 to May, 1991. 6 of them were affected by non toxic multinodular goiter (group 1), while 12 were affected by Graves' disease (group 2). We evaluated their serum levels of calcium, parathormone (iPTH), calcitonin (CT), osteocalcin and total proteins. In both groups we registered a temporary hypocalcemia that resulted statistically significant. In group 1 the hypocalcemia was associated with a decrease in iPTH levels, so that the cause of hypocalcemia in patients submitted to thyroidectomy for nontoxic multinodular goiter seems to be a transient parathyroid failure, while in group 2 the hypocalcemia was associated with a decrease in total protein levels, showing a different pathogenetic mechanism. We conclude that the transitory hypocalcemia post-thyroidectomy relies on a different etiology in the two thyropathies.
在接受甲状腺切除术的患者中，可能会出现暂时性低钙血症，其发生率在国际文献中差异很大。已经提出了几种假说来解释这一现象。本研究将有助于揭示其病因并量化其程度。为此，我们从1989年9月至1991年5月接受手术的患者中选取了一系列病例。其中6例患有非毒性多结节性甲状腺肿（第1组），12例患有格雷夫斯病（第2组）。我们评估了他们的血清钙、甲状旁腺激素（iPTH）、降钙素（CT）、骨钙素和总蛋白水平。在两组中我们都记录到了暂时性低钙血症，且具有统计学意义。在第1组中，低钙血症与iPTH水平降低有关，因此对于因非毒性多结节性甲状腺肿接受甲状腺切除术的患者，低钙血症的原因似乎是短暂性甲状旁腺功能衰竭，而在第2组中，低钙血症与总蛋白水平降低有关，显示出不同的发病机制。我们得出结论，甲状腺切除术后的暂时性低钙血症在两种甲状腺疾病中的病因不同。
