摘要
目的 检测甲状腺术后患者甲状旁腺激素（PTH）及血钙水平,并探讨其与术后症状性低钙血症发生的关系.方法 手术治疗的351例甲状腺疾病患者,对其术后14～16h血钙和PTH水平进行检测.观察发生轻微症状及严重症状的两组患者术后PTH及血钙情况.结果 本组351例患者术前血钙均〉2.0mmol/L,肾功能均正常.58例患者术后出现低钙症状,其中严重症状16例,轻微症状42例.比较血钙〈2.0mmol/L是否产生严重症状时其特异度为83%,敏感度为30%,差异无统计学意义.比较PTH〈0.8pmol/L是否产生严重症状时其特异度为82.0%,敏感度为87.5%,差异有统计学意义.当应用血钙〈2.0mmol/L与PTH〈0.8pmol/L联合检测时其特异度为80.5%,敏感度为85.7%,差异有统计学意义.结论 术后14～16h PTH在预测术后症状性低钙血症方面比血钙敏感,PTH〈0.8pmol/L可作为严重症状性低钙血症的预测指标,临床应用方便.
Objective To investigate＂the relationship among symptomatic hypocalcemia,serum parathyroid hormone（PTH） and serium calcium. Methods The clinical data of 351 cases receiving thy- roidectomy from March 31 st,2010 to August 31 st, 2010 were analyzed. Serum calcium and PTH level were tested after 14 - 16 hours postoperatively. PTH and calcium conditions were compared among the patients with slight or serious symptoms. Results In all 351 cases, the level of preoperative serum calcium was greater than 2.0mmol/L and the renal function was normal. Symptomatic hypocalcemia occurred in 58 ca- ses, including 16 patients with severe symptoms and 42 patients with slight symptoms. The morbidity of hy- pocalcemia of the patients with serum calcium level 〈 2.0 mmol/L was not significant different with that of patients with serum calcium level 〉 2.0 mmol/L; The sensitivity and specificity were 30% and 83% re- spectively. The morbidity of hypocalcemia of the patients with serum PTH level 〈 0.8 pmol/L was signifi- cantly different with that of patients with serum PTH level 〉 0.8 pmol/L. The PTH level 〈 0.8 pmol/L was a predictor of symptomatic hypocalcemia, with sensitivity of 87.5% and specificity of 82.0%. The morbidity of hypocalcemia of the patients with serum calcium level 〈 2.0 mmol/L and PTH level 〈 0.8 pmol/L was significantly different with that of patients with serum calcium level 〉 2.0 mmol/L and PTH level 〈 0.8 pmol/L, with sensitivity of 85.7% and specificity of 80.5%. Conclusion The level of PTH is more sensitive than serum calcium in predicting postoperative hypocalcemia and it（ 〈 0.8 pmol/L）may be a convenient predictor in predicting severe symptomatic hypocalcemia.
出处
《临床外科杂志》
2012年第7期467-468,共2页
Journal of Clinical Surgery
基金
辽宁省（百千万人才工程）资助项目（编号：20109210707）
辽宁省教育厅创新团队资助项目（编号：LT2010102）
