帕米膦酸钠治疗甲状旁腺机能亢进高钙血症的疗效及安全性(附8例报告)

Effect and safety of pamidronate disodium in treatment of primary hypercalcemia due to hyperparathyroidism

目的评价帕米膦酸钠治疗甲状旁腺功能亢进(PHPT)所致高钙血症的疗效和安全性。方法回顾性分析2006-2010年解放军总医院住院的8例PHPT且使用帕米膦酸钠治疗患者入院后14d内的血钙、肌酐、白细胞水平及用药后不良反应。结果帕米膦酸钠用药后第1天即起效,平均血钙由4.02mmol/L降至3.58mmol/L,降低血钙最佳作用时间5-7d,血钙最大降幅为40.0%,其中5例血钙降至正常范围。不良反应:6例出现体温升高(最高39.5℃),最早在用后24h内出现,持续2-5d,经对症治疗均能缓解;1例血白细胞降低至4.0×109/L以下;3例出现血肌酐轻度升高,2例出现膝关节、手指关节痛或肌痛。结论帕米膦酸钠治疗PHPT高钙血症起效快、持续时间长、不良反应轻微,是PHPT患者术前控制血钙的理想药物。

Objective To evaluate the effect and safety of pamidronate disodium in treatment of hypercalcemia due to primary hyperparathyroidism（PHPT）.Methods Blood calcium,creatinine,white blood cells and adverse effects of pamidronate disodium in 8 patients with hypercalcemia due to PHPT 14 days after treatment with pamidronate disodium in Chinese PLA Hospital from 2006 to 2010 were retrospectively analyzed.Results The average serum calcium level decreased to 3.58mmol/L from 4.02mmol/L 1 day after treatment with pamidronate disodium and the best time of pamidronate disodium in reducing the serum calcium level was 5-7 days with a maximal serum calcium decease of 40.0%.Among the 8 patients,the serum calcium level returned to normal in 5 patients.Body temperature was increased in 6 patients and reached to 39.5℃,which occurred within 24h after treatment with pamidronate disodium and continued for 2-5 days,and then decreased after expectant treatment.The number of white blood cells decreased to less than 4.0×10^9/L in 1 patient,the blood creatinine level was mildly increased in 3 patients,and the pain of knee joints,manual intephalangeal joints,and muscle occurred in 2 patients.Conclusion Pamidronate disodium can be used in treatment of hypercalcemia caused by PHPT due to its rapid and long-acting effect,and mild adverse effects.