甲状腺肿或甲状腺乳头状癌患者的血钙正常、亚临床、无症状原发性甲状旁腺功能亢进——初步报告。血钙正常的原发性甲状旁腺功能亢进与甲状腺病理。

Normocalcemic, subclinical, asymptomatic primary hyperparathyroidism in patients with goiter or papillary thyroid cancer--preliminary report. Normocalcemic primary hyperparathyroidism and thyroid pathology.

作者信息

Niedźwiecki Sebastian, Kuzdak Krzysztof, Kaczka Krzysztof, Pomorski Lech

机构信息

Kliniki Chirurgii Endokrynologicznej i Ogólnej Uniwersytetu Medycznego w Lodzi.

出版信息

Wiad Lek. 2007;60(5-6):228-30.

PMID:17966885

Abstract

UNLABELLED

The aim of the prospective study was the evaluation of primary, subclinical, normocalcemic hyperparathyroidism (PHPT) incidence in patients, operated on because of non-toxic (NTG), toxic (TG) goiter and papillary thyroid cancer (PTC).

MATERIAL AND METHODS

The study was performed in the group of 196 patients operated on NTG (115 patients), TG (43 patients) and PTC (38 patients). All patients had never been operated because of goiter. No patient had clinical symptoms of PHPT. Calcium concentration (Ca), phosphorus concentration (P) and alkaline phosphatase activity (ALP) in blood serum were measured in all patients a day before operation. When those parameters were out of range, parathormone concentration (PTH) in blood serum was measured. In the case of elevated PTH concentration PHPT was diagnosed. Furthermore, in order to exclude renal failure and insufficiency tests for creatinine and urea concentrations in blood serum and urinalysis were performed.

RESULTS

There was no case of increased Ca concentration among 158 patients with benign goiter. The values of at least one measured parameters (P or ALP) were abnormal in 47 out of 158 patients with benign goiter (29.7%). Increased PTH concentration (mean 101.5 pg/ml) was in 16 of 47 patients (10.1% of 158 patients). Normocalcemic PHPT was diagnosed in 12 (10.4%) NTG patients and 4 (9.3%) TG patients. In patients with PTC hypercalcemia was not affirmed. In 7 (18.42%) cases of 38 PTC patients P concentration and ALP activity were abnormal. Increased PTH concentration (84.85 pg/ml) was found in one female with PTC with normal values of P and ALP. Incidence of PHPT was observed in 2.63% of PTC patients.

CONCLUSIONS

There was no significant difference of PHPT incidence between various type of goiter. 2. In our study coexistence of PTC and normocalcemic, asymptomatic PHPT is rare.

摘要

未标注

前瞻性研究的目的是评估因非毒性（NTG）、毒性（TG）甲状腺肿和乳头状甲状腺癌（PTC）而接受手术的患者中原发性、亚临床、血钙正常的甲状旁腺功能亢进症（PHPT）的发病率。

材料与方法

该研究在196例因NTG（115例患者）、TG（43例患者）和PTC（38例患者）接受手术的患者组中进行。所有患者既往均未因甲状腺肿接受过手术。无患者有PHPT的临床症状。所有患者在手术前一天测定血清钙浓度（Ca）、磷浓度（P）和碱性磷酸酶活性（ALP）。当这些参数超出范围时，测定血清甲状旁腺激素浓度（PTH）。若PTH浓度升高，则诊断为PHPT。此外，为排除肾衰竭和肾功能不全，进行了血清肌酐和尿素浓度检测及尿液分析。

结果

158例良性甲状腺肿患者中无血钙浓度升高的病例。158例良性甲状腺肿患者中有47例（29.7%）至少一项测量参数（P或ALP）值异常。47例患者中有16例PTH浓度升高（平均101.5 pg/ml）（占158例患者的10.1%）。12例（10.4%）NTG患者和4例（9.3%）TG患者被诊断为血钙正常的PHPT。PTC患者中未证实有高钙血症。38例PTC患者中有7例（18.42%）P浓度和ALP活性异常。在1例P和ALP值正常的PTC女性患者中发现PTH浓度升高（84.85 pg/ml）。PTC患者中PHPT的发病率为2.63%。