甲状旁腺功能亢进症455例临床症状分析

Clinical Symptoms in 455 Hyperparathyroidism Patients

目的分析甲状旁腺功能亢进症(HPT)患者的临床症状特点。方法回顾性分析北京协和医院1974年10月至2009年1月收治的455例HPT患者的临床症状。结果 455例患者中,男156例(34.3%),女299例(65.7%),男女比例1∶1.92;372例(81.8%)出现骨骼系统症状,其中283例(62.2%)表现为骨痛;252例(55.4%)出现泌尿系统症状,其中结石162例(35.6%);200例(44.0%)出现消化系统症状;54例(11.9%)出现神经精神系统非特异性表现;21例(4.6%)患者无临床症状;133例(29.2%)身高降低,平均降低(6.23±5.02)cm;49例(10.8%)出现高钙危象。结论 HPT多见于女性,临床症状以骨骼系统、泌尿系统和消化系统多见。无症状HPT患者比例较低,医师应重视对该病的早期诊断和治疗。

Objective To analyze the clinical symptoms of patients with hyperparathyroidism.Methods The clinical data of 455 patients with hyperparathyroidism who were treated in Peking Union Medical College Hospital from October 1974 to January 2009 were retrospectively analyzed.Results Out of these 455 patients,there were 156 men（34.3%） and 299 women（65.7%）,and the male/female ratio was 1∶1.92.The mean onset age was（40.33±16.61） years（range： 5-86 years）.Most patients（n=372,81.8%） with skeletal manifestations,of whom 283 patients（62.2%） presented with ostealgia.The second most common symptom（n=252,55.4%） was in urinary system,of whom 162 patients（35.6%） had nephrolithiasis.There were 200 patients（44.0%） with digestive system symptoms and 54 patients（11.9%） with neuropsychological symptoms.Twenty-one patients（4.6%） had asymptomatic hyperparathyroidism.There were 133 patients（29.2%） with decreased body height,and the mean decrease was（6.23±5.02）cm.Forty-nine patients（10.8%） presented with hypercalcemia crisis.Conclusions Women are more susceptible to hyperparathyroidism,which is featured by symptoms in skeletal system,urinary system,and digestive system.The asymptomatic hyperparathyroidism is relatively rare,which should be carefully considered during clinical practice.