甲状旁腺切除术对甲状旁腺机能亢进性骨病的远期疗效

Long-TermEficacyofParathyroidectomyonHyperparathyroidBoneDiseaseZhangKeqin,WuZhengyan,XuSongquan,etalDepartmentofEndocrinology,theFirstAffiliatedHospital,NanjingMedicalUniversity,Nanjing210029AbstractThisisaretrospectiveanalysisoflong-termeficacyofparathy

为了评价甲状旁腺切除术对原发性甲状旁腺机能亢进（ＰＨＰＴ）所致骨病的远期疗效，回顾分析了１６例术后平均５．１（１．０～１０．５）年患者的临床表现、骨结构和骨密度恢复情况，结果表明手术虽能明显改善患者骨病，但在随访终点有１０／１６例（６２．５％）骨病恢复不全，其中骨病重的Ｙ１组比骨病轻的Ｙ２组恢复不全比例更高（Ｐ＜０．０５），１４／１６例血骨钙素（ＢＧＰ）和尿吡啶并啉（Ｐｙｒ）浓度处于中青年对照组范围内，这意味着其成骨与破骨处于平衡状态。这些结果提示：ＰＨ－ＰＴ患者应尽早诊断治疗，术后应对患者密切随访。

This is a retrospective analysis of long term efficacy of parathyroidectomy on hyperparathyroid bone disease. The clinical manifestations, bone structure, and bone mineral density in 16 patients averaged 5.1(1.0￣10.5) years after parathyroidectomy were assessed . The results showed that although the bone disease could be markedly relieved after surgery, yet at terminal point of follow up, 10/16 cases (62.5%) got incomplete recovery of bone disease, the ratio of incomplete recovery in Y1 group with severe bone disease was higher than that of Y2 group with mild bone disease ( P <0.05). The concentrations of serum BGP and morning void urine pyridinoline were within the reference ranges of young and middle aged controls. These imply that the osteoblastic and osteoclastic activities had reached a balancing state. The results suggested that hyperparathyroid patients should be operated on as early as possible, and intensively followed up after operation, subsequent therapy should be given to patients with incomplete recovery of bone disease.