發(fā)布時(shí)間：2018-07-13 10:47

【摘要】：目的:探討不同病理類型的原發(fā)性甲狀旁腺功能亢進(jìn)(primary hyperparathyroidism,PHPT)的臨床待征。方法:回顧性分析2010年1月至2016年6月首都醫(yī)科大學(xué)附屬北京世紀(jì)壇醫(yī)院行手術(shù)治療并經(jīng)病理學(xué)檢查確診的140例PHPT患者的臨床資料。結(jié)果:術(shù)后經(jīng)病理學(xué)檢查證實(shí),分為甲狀旁腺癌組(parathyroid carcinoma,PC)13例(9.29%),增生組(parathyroid hyperplasia,PH)27例(19.29%),甲狀旁腺瘤組(parathyroid adenoma,PA)100例(71.43%)。PC組的病程長,PH組的病程PA組(P0.05);PC組年輕患者所占比例較高(P=0.003);PC組病變的直徑PA組,且PA組PH組(P0.05);PC組的血鈣、甲狀旁腺激素(parathyroid hormone,PTH)、堿性磷酸酶(alkaline phosphatase,AKP)、空腹血糖(fasting blood-glucose,FPG)、谷丙轉(zhuǎn)氨酶(alanine aminotransferase,ALT)、谷草轉(zhuǎn)氨酶(aspartate aminotransferase,AST)、谷氨酸轉(zhuǎn)肽酶(glutamete transpeptidase,GGT)、尿素氮(blood urine nitrogen,BUN)、血肌酐(creatine,CRE)最高(P0.05),且尿鈣和尿磷最高(P0.05);PH組血鈣、PTH、AKP、尿鈣均PA組(P0.05);PC組術(shù)后的血鈣最低(P0.001),而PTH水平最高(P0.001);PC、PH、PA組以骨痛表現(xiàn)的比例為46.15%(6/13)、44.44%(12/27)、49.00%(49/100),3組之間差異無統(tǒng)計(jì)學(xué)意義(P0.05);PC組在泌尿系統(tǒng)、消化系統(tǒng)、精神神經(jīng)系統(tǒng)的表現(xiàn)的比例分別為76.92%(10/13)、76.92%(10/13)、15.38%(2/13),高于PH組和PA組(P0.05),其中PH組在泌尿系統(tǒng)表現(xiàn)的比例PA組,PC組病理性骨折、便秘的比例最高30.77%(4/13)、38.46%(5/13)(P0.05)。結(jié)論:PC組的病程較長,發(fā)病年齡較年輕;PC組的病變組織最大,PH組病變組織PA組,術(shù)后PC組的血鈣最低,而PTH水平最高。PC組的生化和臨床表現(xiàn)更為明顯。
[Abstract]:Objective: to investigate the clinical features of primary hyperparathyroidism (primary hyperparathyroidism). Methods: the clinical data of 140 patients with PHPT confirmed by pathology were analyzed retrospectively from January 2010 to June 2016 in Beijing Century altar Hospital affiliated to Capital Medical University. Results: after operation, 13 cases (9.29%) were divided into parathyroid carcinoma group (9.29%), parathyroid hyperplasia PH group (27 cases (19.29%), parathyroid tumor group (parathyroid adenoma PA) 100 cases (71.43%). And the blood calcium of PA group PH group (P0.05) and PC group, Parathyroid, alkaline, fasting blood-glucose, alanine aminotransferase, aspartate aminotransferase, glutamete transpeptidase, (blood urine nitrogenbun, creatine creatinine (CRE), urine calcium and urine phosphorus (P0.05) The serum calcium level in PA group (P0.05) was the lowest (P0.001), while the highest PTH level (P0.001) in PC-PHPA group was 46.15% (6 / 13), 44.44% (12 / 27) and 49.00% (49 / 100). There was no significant difference among the three groups (P0.05). The rates of digestive system and mental nervous system were 76.92% (10 / 13) and 76.92% (10 / 13) / 15.38% (2 / 13), respectively, which were higher than those of PH group and PA group (P0.05). The percentage of pathological fractures in PA group and PC group was 30.77% (4 / 13) and 38.46% (5 / 13) (P0.05). Conclusion the duration of disease is longer in the PC group than in the younger group. The pathological tissue of the PC group is the largest and the serum calcium level is the lowest in the PC group. The biochemical and clinical manifestations of the PC group are more obvious than those of the PC group.
【作者單位】： 首都醫(yī)科大學(xué)附屬北京世紀(jì)壇醫(yī)院內(nèi)分泌科;
【分類號】：R582.1

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