甲状旁腺切除术后血钙正常性高甲状旁腺激素血症的临床研究现状

Research Status of Normocalcemic Parathormone Elevation after Parathyroidectomy

目的阐述原发性甲状旁腺功能亢进(PHPT)患者行甲状旁腺切除术后血钙正常性高甲状旁腺激素血症(NPE)的临床研究现状。方法检索近年来甲状旁腺切除术后NPE的相关文献并进行综述。结果 PHPT患者行甲状旁腺切除术后,绝大多数患者得到了根治性治疗。术后NPE的发生不能预示手术失败,其与PHPT复发的关系仍需进一步探讨。甲状旁腺切除术后NPE患者发生心血管疾病的风险较高,术后适当补充维生素D及钙剂可降低NPE的发生风险。结论目前对甲状旁腺切除术后NPE患者的转归情况仍不太清楚,进一步实施多中心、大样本的临床随机对照试验及进行长期随访十分有必要。

Objective To summarize the research status of normocalcemic parathormone elevation after parathyroidectomy for patients with primary hyperparathyroidism. Methods The related literatures on normocalcemic parathormone elevation after parathyroidectomy were collected and reviewed. Results Most of the patients with primary hyperparathyroidism received radical treatment postoperation. NPE didn＇t predict failure of operation. The relationship between normocalcemic parathormone elevation and recurrent primary hyperparathyroidism remained to be further explored. Patients with normocalcemic parathormone elevation after parathyroidectomy had a higher risk of cardiovascular disease. Postoperative vitamin D and calcium supplementation could reduce the incidence of normocalcemic parathormone elevation. Conclusions The clinical significance of normocalcemic parathormone elevation is still unknown at present. Further researches of multicenter, huge sample, and long-term follow-up will be necessary.