摘要
目的探讨原发性甲状旁腺功能亢进症合并高钙危象(primary hyperparathyroidism-induced hypercalcemic crisis,PHIHC)患者的临床特点。方法选取1993年1月~2015年12月北京积水潭医院收治的原发性甲状旁腺功能亢进症合并高钙危象患者22例,患者入院时随机血钙水平≥3.5mmol/L并伴有多系统受累表现。回顾性分析PHIHC患者的临床资料,并在人口学资料、实验室检测指标及病理类型方面与同期不伴有高钙危象的原发性甲状旁腺功能亢进症(primary hyperparathyroidism,PHPT)患者进行比较。结果本组PHIHC患者骨骼系统、泌尿系统受累率分别为95.5%和57.1%。甲状旁腺B超和^(99 m)Tc-甲氧基异丁基异腈(MIBI)肿瘤定位率分别为90.5%和100%。与同期不伴有高钙危象的PHPT患者相比,PHIHC组男性更为多见(P<0.05),血钙、24h尿钙、全段甲状旁腺激素水平和肌酐水平更高,差异有统计学意义(P均<0.05),但血磷、血碱性磷酸酶水平在两组间差异无统计学意义(P均>0.05)。PHIHC组与PHPT不伴高钙危象组的病理类型构成差异无统计学意义(P>0.05),但PHIHC组病灶质量及直径更大(P均<0.05)。结论本组PHIHC患者男性更多见,骨骼系统受累严重,有更高的血钙、甲状旁腺激素水平及更大的肿瘤质量和直径,甲状旁腺B超和^(99 m)Tc-甲氧基异丁基异腈(MIBI)显像有助于PHIHC患者肿瘤定位。
Objective To investigate the clinical characteristics of patients with primary hyperparathyroidism-induced hypercalcemic crisis （PHIHC）.Methods Twenty-two patients diagnosed with PHIHC in Beijing Jishuitan Hospital were enrolled in this study from January 1993 to December 2015. All the patients had a randomized blood calcium levels ≥ 3.5mmol/L and accompanied by multi-system impairment. The clinical data of PHIHC patients were retrospectively analyzed and then compared with the data of patients with primary hyperparathyroidism （PHPT） without calcium crisis in terms of demographic data, laboratory test indicators and pathological types.Results The involvement rate of skeletal system and urinary system in patients with PHIHC was 95.5% and 57.1%, respectively. The tumor localization rate of ultrasonography and ^99mTc-methoxy isobutyl cyanide （MIBI） in PHIHC group was 90.5% and 100%, respectively. Compared with PHPT patients without calcium crisis, PHIHC patients had more frequency in men than women （P 〈0.05） and higher levels of serum calcium, 24 hours urinary calcium, intact parathyroid hormone and creatinine （P all 〈0.05）. But in the levels of serum phosphorus and serum alkaline phosphatase, there was no significant difference between the two groups （P all 〉0.05）. Although there was no significant difference in the pathological type between PHIHC group and PHPT group, the tumor mass and size in PHIHC group were larger （P all 〈0.05）.Conclusion The PHIHC patients in this study had more frequency in men than women and significant skeletal involvement, higher levels of serum calcium and parathyroid hormone and greater tumor mass and size. The ultrasonography and 99mTc-methoxy isobutyl cyanide （MIBI） imaging were helpful for tumor localization.
出处
《医学研究杂志》
2017年第12期112-115,共4页
Journal of Medical Research
