血钙正常的原发性甲状旁腺功能亢进症

Normocalcemic primary hyperparathyroidism

血钙正常的原发性甲状旁腺功能亢进症是近年来逐渐被认识的疾病,其诊断要点是血总钙、血离子钙水平持续正常,血甲状旁腺素(parathyroid hormone,PTH)水平升高,同时需除外继发性甲状旁腺功能亢进的因素。其诊断多在进行骨质疏松症或其他疾病检查时发现,部分患者临床无症状,部分有骨质疏松、骨折、肾结石等靶器官损害或代谢异常。关于其发病机制、临床表现、自然进程、转归目前尚无统一意见,双膦酸盐、拟钙剂药物治疗及手术切除治疗或有益处。

Normocalcemic primary hyperparathyroidism is a disease being recognized recently. It is diagnosed by consistently normal levels of serum total caleium and ionized calcium combined with elevated parathyroid hormone （PTH） levels, excluding of secondary, causes of hyperparathyroidism. It is found mostly in patients referred for osteoporosis, kidney stones or other diseases. Some patients are asymptomatic, but some have osteoporosis, fractures, kidney stones and other target organ damage or metabolic abnormalities. There is no consensus about its pathogenesis, clinical manifestation, natural proeess and outcomes. It is reported that bisphosphonates, cinacalcet or surgical resection may be effective.