Koppelberg T, Bartsch D, Printz H, Hasse C, Rothmund M
Klinik für Allgemeinchirurgie, Universität Marburg.
Dtsch Med Wochenschr. 1994 May 20;119(20):719-24. doi: 10.1055/s-2008-1058752.
Pancreatitis occurred in 13 (5.6%) of 234 patients (76 men, 158 women; mean age 63 [2-83] years) who were operated on for primary hyperparathyroidism (pHPT) between 1987 and 1992. The pancreatitis patients had a significantly higher median level of parathormone (340 pg/ml), of serum calcium (3.2 mmol/l) and of thyroid weight (1.7 g) than the remaining 221 patients (135 pg/ml; 2.9 mmol/l; 1.0 g, respectively: P < 0.05 for each). In ten patients pHPT had been diagnosed during an attack of pancreatitis: pancreatitis had been the diagnostic clue to pHPT. After conservative treatment of the pancreatitis and parathyroidectomy seven of the ten patients were free of symptoms during the follow-up. In one patient pancreatitis recurred postoperatively and two patients died of the consequences of haemorrhagic necrotizing pancreatitis. Cholelithiasis, as another possible causative factor for pancreatitis, was present in five of the 13 patients (38%). None of the patients was an alcoholic. These data indicate that there is a positive correlation between advanced pHPT and pancreatitis. Pancreatitis may be the expression of much advanced hyperparathyroidism which has been diagnosed too late.
1987年至1992年间，234例接受原发性甲状旁腺功能亢进症（pHPT）手术的患者（76例男性，158例女性；平均年龄63岁[2 - 83岁]）中，有13例（5.6%）发生了胰腺炎。胰腺炎患者的甲状旁腺激素中位水平（340 pg/ml）、血清钙水平（3.2 mmol/l）和甲状腺重量（1.7 g）显著高于其余221例患者（分别为135 pg/ml；2.9 mmol/l；1.0 g：每项P < 0.05）。10例患者在胰腺炎发作期间被诊断出患有pHPT：胰腺炎是诊断pHPT的线索。在对胰腺炎进行保守治疗和甲状旁腺切除术后，10例患者中有7例在随访期间无症状。1例患者术后胰腺炎复发，2例患者死于出血性坏死性胰腺炎的后果。作为胰腺炎另一个可能病因的胆石症，在13例患者中有5例（38%）存在。所有患者均非酗酒者。这些数据表明晚期pHPT与胰腺炎之间存在正相关。胰腺炎可能是甲状旁腺功能亢进症过于严重且诊断过晚的一种表现。
