甲状旁腺功能减退症继发低钙性肌病的临床分析

Clinical Features of Hypocalcemic Myopathy Secondary to Hypoparathyroidism

目的观察甲状旁腺功能减退症继发低钙性肌病的临床特征。方法对13例甲状旁腺功能减退症继发低钙性肌病患者的临床表现、实验室检查特点和治疗方法进行回顾。结果 13例患者分别为原发性甲状旁腺功能减退症8例,继发性3例,假性2例。继发低钙性肌病表现为发作性手足搐搦,发作性双手足、前臂、小腿痉挛且疼痛,还可见眼睑痉挛、躯干痉挛、咽喉痉挛。部分患者Trousseau征和Chvostek征阳性。血清肌酸激酶、乳酸脱氢酶水平升高。经给予足量碳酸钙和骨化三醇治疗,患者肌肉病症状缓解,肌酶恢复正常。结论原发性、继发性或假性甲状旁腺功能减退症均可引起低钙血症,导致肌肉疾病,补充足量碳酸钙和骨化三醇有效。

Objective To observe the features of hypocalcemic myopathy secondary to hypoparathyroidism （HP）. Methods The symp- toms and signs, laboratory findings and treatments of 13 patients with hypocalcemic myopathy secondary to HP were analyzed retrospectively. Results 13 cases of liP were classified into idiopathic HP （8 cases）, secondary HP （3 cases） and pseudo-HP （2 cases）. The symptoms of hypocalcemic myopathy secondary to HP included tetany, episodic carpopedal spasm, muscle cramps and myalgias in the forearms and calves. It presented blepharospasm, trunk spasm and laryngospasm. Some patients demonstrated positive Trousseau＇s and Chvostek＇s sign. Serum level of creatine kinase （CK） and lactate dehydrogenase （LDH） increased. The symptoms of myopathy released and the levels of CK and LDH decreased to normal level after enough calcium carbonate and calcitriol administration. Conclusion All types of HP （idiopathic, secondary and pseudo HP） can cause hypocalcemia and myopathy. Hypocalcemic myopathy secondary to HP would well recover by enough calcium carbonate and calcitriol treatment.