继发性甲状旁腺功能亢进症的研究进展

Research progress of Secondary hyperparathyroidism

甲状旁腺是一种独特的内分泌器官,在慢性肾脏病的进展过程中,静止的腺细胞开始增殖以满足钙磷代谢的需求,从而导致继发性甲状旁腺功能亢进。继发性甲状旁腺功能亢进症(secondary hyperparathyroidism, SHPT)是一种适应性疾病,可因肾功能下降、磷酸盐排泄受限以及无法激活维生素D等因素而进展,成为慢性肾脏病患者经常遇到的挑战。高水平的甲状旁腺激素(parathyroid hormone, PTH)将逐步导致慢性肾脏病-矿物质和骨异常的发生,从而出现多系统的严重并发症。长期处于慢性肾衰竭的SHPT患者会逐渐对常用药物产生抵抗力,此时,采用甲状旁腺切除术(parathyroidectomy, PTX)治疗是更好的选择。本文将从SHPT的发病机制、诊断、临床症状及治疗进展等多方面进行介绍。

Parathyroid gland is a unique endocrine organ.During the progression of chronic kidney disease, the resting glandular cells begin to proliferate to meet the demands of calcium and phosphorus metabolism, leading to secondary hyperparathyroidism(SHPT).SHPT is an adaptive disease that can progress due to decreased renal function, limited phosphate excretion, and inability to activate vitamin D,which is a frequent challenge for patients with chronic kidney disease.The high levels of parathyroid hormone(PTH) will gradually lead to chronic kidney disease-mineral and bone abnormalities, resulting in serious complications of multiple systems.The patients with SHPT complicated by chronic renal failure will gradually develop resistance to commonly used drugs.At this time, parathyroidectomy(PTX) may be a better option. This article will review the pathogenesis, clinical symptoms, diagnosis and treatment progress of secondary hyperparathyroidism.