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骨病患者中甲状旁腺功能亢进筛查的意义

Importance of screening hyperparathyroidism in osteopathia patients
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摘要 目的强调骨病患者中原发性甲状旁腺功能亢进(pHPT)筛查的必要性,探讨可行的筛查方法。方法对我院12年内105例原发性甲状旁腺功能亢进患者的收治资料进行回顾性分析。结果105例患者中103例来源于骨科门诊,2例收自于外科门诊,均患有不同程度的骨病。骨科症状病程0~240个月,中位数36个月。其中102例曾就诊二级以上医院(骨科)数2~7家,平均3家。误诊时间0~480月,中位数24个月,诊断以骨质疏松、骨肿瘤、病理性骨折最为常见,且治疗效果不佳或加重。105例患者中95例(90.5%)血钙高于正常,84例(80.0%)血磷低于正常,98例(93.3%)碱性磷酸酶(ALP)高于正常,3项指标均正常者仅1例。105例患者甲状旁腺激素均升高,是正常值高限的20.83±13.74倍。结论骨病患者中甲状旁腺功能亢进的筛查是有意义的,骨生化检查表现为血钙升高、血磷降低及碱性磷酸酶升高就能最大程度地筛选出骨病患者中pHPT患者。 Objective To emphasize the necessity of screening primary hyperparathyroidism(pHPT)in orthopathia patients,and explore the feasible screening methods.Methods The data of 105 patients with primary hyperparathyroidism in our hospital in the past 12 years were analyzed retrospectively.Results Of the 105 patients,103 were from the orthopaedic clinic,and 2 were from the surgical clinic.All of them suffered from different degrees of bone diseases.The course of symptoms ranged from 0 to 240 months,with a median of 36 months.Among 105 patients,102 patients had visited 2-7 hospitals(orthopedics)at or above the second level,with an average of 3 hospitals.The misdiagnosis time was 0-480 months,with a median of 24 months.The misdiagnosis were commonly found in patietns with osteoporosis,bone tumors,and pathological fractures,and the diseases were poorly treated or aggravated.Among 105 patients,95(90.5%)had a concentration of blood calcium higher than the normal,84(80.0%)had a concentration of blood phosphorus lower than the normal,98(93.3%)had a concentration of alkaline phosphatase(ALP)higher than the normal,and only one patient had three normal indexes.Parathyroid hormone was increased,which was 20.83±13.74 times of the high limit of normal value.Conclusion The screening of hyperparathyroidism in orthopathia patients is meaningful.Elevated blood calcium,decreased blood phosphorus,and elevated alkaline phosphatase can screen out pHPT patients in orthopathia patients to the greatest extent.
作者 谭屾 崔爱民 柏楠 卢帅 查晔军 TAN Shen;CUI Aimin;BAI Nan;LU Shuai;ZHA Yejun(Department of General Surgery,Beijing Jishuitan Hospital,Capital Medical University,Beijing 102208,China;Department of Trauma Orthopedics,Beijing Jishuitan Hospital,Capital Medical University)
出处 《山西医科大学学报》 CAS 2023年第9期1280-1284,共5页 Journal of Shanxi Medical University
基金 北京市自然科学基金-海淀原始创新联合基金资助项目(L192049)。
关键词 原发性甲状旁腺功能亢进 血钙 甲状旁腺素 血磷 碱性磷酸酶 primary hyperparathyroidism blood calcium parathyroid hormone blood phosphorus alkaline phosphatase
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