甲状旁腺全切加前臂移植术对甘油三酯代谢的影响

Effect of Total Parathyroidectomy and Forearm Autotransplantation on Triglyceride Metabolism in Patients with Secondary Hyperparathroidism

目的:探讨甲状旁腺全切(PTX)加前臂移植术对血清甘油三酯(TG)代谢的有益作用。方法:观察10例继发性甲状旁腺功能亢进(SHPT)患者手术前、后3～68个月TG的浓度,同时检测血清全段甲状旁腺素(iPTH),并将手术前后的TG、iPTH作相关分析。结果:7例患者PTX1月后,血TG开始降低,术后3个月,10例患者的平均TG由术前(2.34±0.72)mmol/L降至(1.51±0.54)mmol/L。随访2～6年,疗效稳定可靠。PTX前、后TG的改变差异有显著性(P<0.05)。iPTH也由术前(1484.75±72.40)pg/ml降为(50.13±9.30)pg/ml。TG与iPTH呈正相关。结论:PTX能明显改善慢性肾功能衰竭患者合并SHPT的TG代谢。

Objective:To investigate the beneficial effect of total parathyroidectomy and forearm autotransplantation on triglyceride metabolism in 10 patients with secondary hyperparathyroidism. Methods: Before the operation and 3-68 months after the operation, the levels of plasma triglyceride and iPTH in 10 patients were monitored. Results:One month after the operation, the level of triglyceride declined in 7 patients.The level of triglyceride was significantly reduced 3 months after the operation in 10 patients ([2.34±0.72 ]mmol/L vs [1.51 ±0.54 ]mmol/L,P<0.05).The beneficial effect was stable for 2-6 years by follow-up.The level of iPTH was decreased significantly ([1484.75±72.40]pg/ml vs[50.13±9.30]pg/ml). There was a positive correlation between the levels of triglyceride and iPTH.Conclusion:Total parathyroidectomy and forearm autotransplantation has a beneficial effect on triglyceride metabolism in patients with secondary hyperparathyroidism.