高频彩超在慢性肾功能不全继发甲状旁腺功能亢进中的应用价值

High frenquency color ultrasonography in secondary hyperparathyroidism following chronic renal failure

目的探索高频彩色多普勒超声对慢性肾功能不全继发甲状旁腺功能亢进(SHP)的诊断价值。方法研究高频超声测量甲状旁腺的数量、直径、周长、面积及其血流情况与96例慢性肾功能不全SHP患者血钙、血磷、钙磷乘积及PTH水平之间的关系。结果96例患者共检测到增生的甲状旁腺132枚,平均数量为(1.9±0.7)枚;平均直径为(0.63±0.43)cm,平均周长为(2.03±1.18)cm,平均面积为(0.46±0.36)cm2。增生的甲状旁腺多位于甲状腺中下极,呈实性低回声,形态多样,血流信号较丰富;增生甲状旁腺数量不同,其各组血钙、血磷、钙磷乘积、血PTH浓度均无统计学差异;而反映增生甲状旁腺大小的指标——直径、周长、面积与血钙、血PTH呈正相关性,与血磷无相关性。结论高频彩超检测的甲状旁腺直径、周长、面积与血钙、血PTH呈正相关性,可间接反映SHP病情程度,在SHP的诊断与治疗中不失为有效影像学方法之一。

Objective To investigate the diagnostic value of color Doppler ultrasonography with high frenquency probe in secondary hyperparathyroidism （SHP） following chronic renal failure. Methods To study the relationship among parathyroid number, diameter, perimeter, area and blood flow perfusion detected by high frenquency ultrasond and the serum level of calcium, phosphorus and parathyroid hormone （PTH） of 96 chronic renal failure patients. Results Totally 132 hyperplastic parathyroids were detected in 96 patients, average number of which was （1.9±0.7）, average diameter was （0.63± 0.43）era, average perimeter was （2.03±1.18）era, and average area was （0.46±0.36）cm^2. The hyperplastic parathyroids were mostly located in lower pole of thyroid, hypoeehoie, variety shape and rich color flow. There was no statistic difference among groups of different number of hyperplastie parathyroid in serum level of calcium, phosphate, PTH and calcium-phosphorus product. The indices representing parathyroid size, such as diameter, perimeter and area were positive related to the serum level of calcium and PTH, but not related to the serum level of phosphorus. Conclusion High frequency color ultrasound was an effective imaging method in SHP diagnosis and therapy, which indices of parathyroid diameter, perimeter and area were positively related to the serum level of calcium and PTH, and indirectly reflected the state of SHP.