Manning E M, Fraser W D
University Department of Clinical Chemistry, Royal Liverpool University Hospital, UK.
Ann Clin Biochem. 1993 May;30 ( Pt 3):252-5. doi: 10.1177/000456329303000304.
Intact parathyroid hormone (PTH) was analysed in 1107 samples over a 13 month period. Of these, 181 samples (16%) gave results of < or = 1 pmol/L and the case notes of 169 of these 181 patients were examined. Eighty-two patients (48%) were hypercalcaemic at the time of the PTH assay. As expected, the most common diagnosis in this group was hypercalcaemia of malignancy but surprisingly this accounted for only 42 of the hypercalcaemic patients; an unexpectedly high proportion (20 patients) had chronic renal failure with hypercalcaemia due to excessive treatment with 1 alpha-hydroxycholecalciferol; eight patients had transient unexplained hypercalcemia and the remaining 12 patients were hypercalcaemic for a variety of causes including immobilization, bendrofluazide treatment and Paget's disease. Fifty-nine patients (35%) were normocalcaemic: 26 had osteoporosis, 10 had chronic renal failure and the remainder had a wide range of diagnoses. It is possible that the low intact PTH result in a proportion of the normocalcaemic group was caused by ingestion of calcium tablets prior to blood sampling for PTH. Twenty-eight patients (17%) were hypocalcaemic: 24 of these had hypoparathyroidism, two had chronic renal failure and two had transient unexplained hypocalcaemia.
在13个月的时间里，对1107份样本进行了完整甲状旁腺激素（PTH）分析。其中，181份样本（16%）的检测结果≤1 pmol/L，并对这181例患者中的169例的病历进行了检查。82例患者（48%）在进行PTH检测时存在高钙血症。正如预期的那样，该组中最常见的诊断是恶性肿瘤导致的高钙血症，但令人惊讶的是，这仅占高钙血症患者的42例；比例出乎意料地高（20例患者）患有慢性肾衰竭并因过量使用1α-羟胆钙化醇而导致高钙血症；8例患者有短暂不明原因的高钙血症，其余12例患者因各种原因出现高钙血症，包括制动、苄氟噻嗪治疗和佩吉特病。59例患者（35%）血钙正常：26例患有骨质疏松症，10例患有慢性肾衰竭，其余患者有广泛的诊断结果。血钙正常组中一部分患者PTH结果偏低，可能是由于在采集PTH血样前服用了钙片所致。28例患者（17%）存在低钙血症：其中24例患有甲状旁腺功能减退症，2例患有慢性肾衰竭，2例有短暂不明原因的低钙血症。
