摘要
目的本研究回顾性分析较大样本量高钙危象病例的病因、临床表现、急诊救治及病因治疗。方法分析2009年1月至2022年7月中国人民解放军总医院第一医学中心救治的高钙危象患者的一般资料、临床表现、病因、影像学检查、急诊救治、病因治疗、治疗前后血清学检查对比、病理免疫组化结果、随访转归。结果本研究共纳入143例高钙危象患者(男性84例,女性59例),平均年龄为(53.51±16.60)岁。最常见罹患的是甲状旁腺功能亢进症(62/143),其次是实体恶性肿瘤(57/143),再次为多发性骨髓瘤(12/143)。患者临床表现为消化系统症状占76.91%,神经系统症状占63.60%,泌尿系统症状占58.76%,骨骼系统症状占55.23%,心血管系统症状占32.91%。143例患者中,经水化补液、降钙素、双膦酸盐、血液透析等急诊降钙治疗后高钙危象好转率为100%(143/143),经病因治疗后高钙血症好转率为85.31%(122/143)。结论高钙危象的早期识别、急诊救治以及病因治疗非常重要。急诊有效的综合降钙措施可以使临床症状迅速缓解,为病因治疗创造条件。针对性病因治疗可以取得高钙血症的纠正或长期缓解。
Objective The study retrospectively analyzed the etiology,clinical manifestations,emergency treatment and etiological treatment of a large sample of cases with hypercalcemic crisis.Methods The clincial data of patients with hypercalcaemia cirisis who were administered in First Medical Center of Chinese PLA General Hospital from January 2009 to July 2022 were analyzed,inculding the general data,clinical manifestations,etiology,photographic examination,emergency treatment,etiological treatment,serological examination before and after treatment,pathological immunohistochemical findings and prognosis.Results A total of 143 hypercalcaemia crisis patients(84 males and 59 females)with a mean age of 53.51±16.60 were enrolled.The most common disease was hyperparathyroidism(62/143),followed by solid malignancy(57/143)and multiple myeloma(12/143).Patients presented with digestive system symptoms at 76.91%,followed by neurological symptoms at 63.60%,urinary system symptoms at 58.76%,musculoskeletal symptoms at 55.23%,and cardiovascular system symptoms at 32.91%.After emergency calcium-lowering treatment,the remission rate of hypercalcemic crisis in 143 patients was 100%(143/143),and after etiological treatment,the remission rate of hypercalcemia was 85.31%(122/143).Conclusion Early identification,emergency treatment and etiology treatment of hypercalcaemia crisis are essential.Effective treament with comprehensive calcium reduction can quickly relieve clinical symptoms and create opportunities for treatment for the cause.Targeted etiological interventions can lead to the correction or long-term remission of hypercalcemia.
作者
刘洋
王先令
郭清华
杜锦
裴育
巴建明
谷伟军
窦京涛
吕朝晖
母义明
Liu Yang;Wang Xianling;Guo Qinghua;Du Jin;Pei Yu;Ba Jianming;Gu Weijun;Dou Jingtao;Lyu Zhaohui;Mu Yiming(Department of Endocrinology,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China;the Department of Endocrinology,Shexian Hospital,Handan 056400,China)
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2024年第2期115-120,共6页
Chinese Journal of Endocrinology and Metabolism
关键词
高钙危象
急诊救治
病因
临床表现
Hypercalcaemia crisis
Emergency treatment
Cause of disease
Clinical manifestation
