Huang Y Y, Hsu B R, Huang B Y, Huang H S, Huang M J
Department of Internal Medicine, Chang-Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
J Clin Ultrasound. 1994 Mar-Apr;22(3):193-7. doi: 10.1002/jcu.1870220309.
To investigate the value of serum alkaline phosphatase in evaluating hyperplasia of parathyroid glands in hemodialysis patients, 28 hemodialysis patients who had parathyroid sonography examinations for secondary hyperparathyroidism were studied retrospectively. There were significant elevations of serum alkaline phosphatase, parathyroid hormone (PTH), serum total calcium, and dialysis duration in patients with sonography-detectable parathyroid (N = 17) as compared with those of sonography-undetectable (N = 11) parathyroid. Hemodialysis patients who have both higher serum alkaline phosphatase (> 94 IU/L) and considerably elevated serum PTH (9 x or higher) are likely to have sonography-detectable parathyroids (positive predictive value of 93%). Patients with mildly or moderately elevated serum PTH but normal serum alkaline phosphatase are less likely to have sonography-detectable parathyroids (negative predictive value is 100%). These findings suggest that the elevation of serum alkaline phosphatase could be a valuable parameter in addition to the high serum PTH level in predicting hyperplasia of parathyroid glands in chronic hemodialysis patients.
为研究血清碱性磷酸酶在评估血液透析患者甲状旁腺增生中的价值，对28例因继发性甲状旁腺功能亢进接受甲状旁腺超声检查的血液透析患者进行了回顾性研究。与超声检查未发现甲状旁腺的患者（N = 11）相比，超声检查可发现甲状旁腺的患者（N = 17）的血清碱性磷酸酶、甲状旁腺激素（PTH）、血清总钙和透析时间均显著升高。血清碱性磷酸酶较高（> 94 IU/L）且血清PTH显著升高（9倍或更高）的血液透析患者很可能有超声可检测到的甲状旁腺（阳性预测值为93%）。血清PTH轻度或中度升高但血清碱性磷酸酶正常的患者不太可能有超声可检测到的甲状旁腺（阴性预测值为100%）。这些发现表明，除了高血清PTH水平外，血清碱性磷酸酶升高可能是预测慢性血液透析患者甲状旁腺增生的一个有价值的参数。
