140例原发性甲状旁腺功能亢进患者临床资料分析

发布时间：2018-07-13 10:47

【摘要】：目的:探讨不同病理类型的原发性甲状旁腺功能亢进(primary hyperparathyroidism,PHPT)的临床待征。方法:回顾性分析2010年1月至2016年6月首都医科大学附属北京世纪坛医院行手术治疗并经病理学检查确诊的140例PHPT患者的临床资料。结果:术后经病理学检查证实,分为甲状旁腺癌组(parathyroid carcinoma,PC)13例(9.29%),增生组(parathyroid hyperplasia,PH)27例(19.29%),甲状旁腺瘤组(parathyroid adenoma,PA)100例(71.43%)。PC组的病程长,PH组的病程PA组(P0.05);PC组年轻患者所占比例较高(P=0.003);PC组病变的直径PA组,且PA组PH组(P0.05);PC组的血钙、甲状旁腺激素(parathyroid hormone,PTH)、碱性磷酸酶(alkaline phosphatase,AKP)、空腹血糖(fasting blood-glucose,FPG)、谷丙转氨酶(alanine aminotransferase,ALT)、谷草转氨酶(aspartate aminotransferase,AST)、谷氨酸转肽酶(glutamete transpeptidase,GGT)、尿素氮(blood urine nitrogen,BUN)、血肌酐(creatine,CRE)最高(P0.05),且尿钙和尿磷最高(P0.05);PH组血钙、PTH、AKP、尿钙均PA组(P0.05);PC组术后的血钙最低(P0.001),而PTH水平最高(P0.001);PC、PH、PA组以骨痛表现的比例为46.15%(6/13)、44.44%(12/27)、49.00%(49/100),3组之间差异无统计学意义(P0.05);PC组在泌尿系统、消化系统、精神神经系统的表现的比例分别为76.92%(10/13)、76.92%(10/13)、15.38%(2/13),高于PH组和PA组(P0.05),其中PH组在泌尿系统表现的比例PA组,PC组病理性骨折、便秘的比例最高30.77%(4/13)、38.46%(5/13)(P0.05)。结论:PC组的病程较长,发病年龄较年轻;PC组的病变组织最大,PH组病变组织PA组,术后PC组的血钙最低,而PTH水平最高。PC组的生化和临床表现更为明显。
[Abstract]:Objective: to investigate the clinical features of primary hyperparathyroidism (primary hyperparathyroidism). Methods: the clinical data of 140 patients with PHPT confirmed by pathology were analyzed retrospectively from January 2010 to June 2016 in Beijing Century altar Hospital affiliated to Capital Medical University. Results: after operation, 13 cases (9.29%) were divided into parathyroid carcinoma group (9.29%), parathyroid hyperplasia PH group (27 cases (19.29%), parathyroid tumor group (parathyroid adenoma PA) 100 cases (71.43%). And the blood calcium of PA group PH group (P0.05) and PC group, Parathyroid, alkaline, fasting blood-glucose, alanine aminotransferase, aspartate aminotransferase, glutamete transpeptidase, (blood urine nitrogenbun, creatine creatinine (CRE), urine calcium and urine phosphorus (P0.05) The serum calcium level in PA group (P0.05) was the lowest (P0.001), while the highest PTH level (P0.001) in PC-PHPA group was 46.15% (6 / 13), 44.44% (12 / 27) and 49.00% (49 / 100). There was no significant difference among the three groups (P0.05). The rates of digestive system and mental nervous system were 76.92% (10 / 13) and 76.92% (10 / 13) / 15.38% (2 / 13), respectively, which were higher than those of PH group and PA group (P0.05). The percentage of pathological fractures in PA group and PC group was 30.77% (4 / 13) and 38.46% (5 / 13) (P0.05). Conclusion the duration of disease is longer in the PC group than in the younger group. The pathological tissue of the PC group is the largest and the serum calcium level is the lowest in the PC group. The biochemical and clinical manifestations of the PC group are more obvious than those of the PC group.
【作者单位】：首都医科大学附属北京世纪坛医院内分泌科;
【分类号】：R582.1

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