160例原发性甲状旁腺功能亢进症患者临床资料初步分析

Preliminary analysis of clinical presentations of 160 cases primary hyperparathyroidism

目的:分析瑞金医院收治的原发性甲状旁腺功能亢进症(primary hyperparathyroidism,PHPT)患者的临床特征。方法:收集瑞金医院1956年至2005年间收治的PHPT患者临床资料;比较1956年9月至2001年8月(组1)与2001年9月至2005年12月(组2)PHPT患者间临床表现的异同。结果:160例PHPT患者,经明确病理诊断者有151例,未手术者9例。校正住院人数后发现,1996年至2005年患者数仍增加1.65倍。我院PHPT患者临床特征:①平均起病年龄为39岁,但病程长,中位数为4年。②首诊科室因患者临床表现多样而分布广泛,内分泌科(32.1%)和泌尿外科(28.4%)列就诊人数前2位。③首发症状:总组中虽仍以肾骨混合型(38.8%)和骨型(33.1%)为多见,但组2中以单纯骨型及肾骨混合型起病的患者明显少于组1,而以肾型及单纯高钙型起病的患者开始增多。④临床表现:患者症状典型,生化改变明显。但两组的泌尿系统表现有显著差异,组1为58%,组2为82.9%(P=0.026)。结论:我院PHPT患者起病年龄小,病程长,首发症状表现多样。近年来,以泌尿系统异常为起病的PHPT患者增多,但其血钙和血PTH仍明显超出正常范围,表现为传统的PHPT临床特点。

Objective To study the clinical characteristics of primary hyperparathyroidism （PHPT） patients in Ruijin Hospital. Methods 160 PHPT patients admitted to Ruijin Hospital between Sept.1956 and Dec.2005 were analyzed. Their clinical patterns were compared between those treated during Sept.1956-Aug.2001 （group 1） and Sept. 2001-Dec.2005 （group 2）. Results There was a 1.65 time increase in the number of PHPT patients admitted to our department from 1996 to 2005. The patients presented their initial manifestations at age of 39, with the median duration of the disease 4 years. Patients still showed classical manifestations with high level of serum calcium and PTH. However, its pattern seems to have some changes in the recent 5 years： group 2 had more urinary and hypercalcemic symptoms than group 1. Conclusions The PHPT patients had younger onset age and longer duration before the final diagnosis. The clinical manifestations of the patients were still in its classical form.