Madira W, Robertson G S, London N J, Iqbal S J, Bell P R, Veitch P S
Department of Surgery, Leicester Royal Infirmary.
Ann R Coll Surg Engl. 1993 Jan;75(1):26-9.
Intact parathyroid hormone (PTHi) has a relatively short half-life and levels fall significantly within 15 min of the successful excision of all the abnormal parathyroid glands during surgery for hyperparathyroidism. Monitoring this fall has been suggested as useful in decreasing the failure rate of neck explorations in parathyroid surgery. We have performed a comparative study of the use, during surgery for primary hyperparathyroidism, of routine frozen section with the recently available rapid assay for PTHi. The assay demonstrated a significant fall (P = 0.013) in the level of PTHi from a pre-excision mean of 26.66 pmol/l to 5.94 pmol/l 15 min after surgical excision. In all cases the level of PTHi fell to less than 30% of pre-excision levels by 30 min. However, while frozen section results were available in a mean time of 22 min after excision, the PTHi levels took a mean of 105 min. We conclude that during straightforward parathyroid surgery for primary hyperparathyroidism, the current assay does not offer any advantages over the already routine use of frozen section.
完整的甲状旁腺激素（PTHi）半衰期相对较短，在甲状旁腺功能亢进手术中成功切除所有异常甲状旁腺后的15分钟内，其水平会显著下降。有人认为监测这种下降有助于降低甲状旁腺手术中颈部探查的失败率。我们对原发性甲状旁腺功能亢进手术中常规冷冻切片与最近可用的PTHi快速检测方法的使用进行了一项比较研究。该检测显示，PTHi水平从切除前的平均26.66 pmol/l显著下降至手术切除后15分钟的5.94 pmol/l（P = 0.013）。在所有病例中，到30分钟时PTHi水平降至切除前水平的30%以下。然而，虽然冷冻切片结果在切除后平均22分钟即可获得，但PTHi水平平均需要105分钟。我们得出结论，在原发性甲状旁腺功能亢进的直接甲状旁腺手术中，目前的检测方法与已经常规使用的冷冻切片相比没有任何优势。
