[无症状原发性甲状旁腺功能亢进症的回顾性临床研究]。

X T Huang, L Zong, B Ma, Y X Zhang, X H Du, J D Zhao, Y P Zhang
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引用次数: 0

摘要

目的总结和分析无症状原发性甲状旁腺功能亢进症(aPHPT)的诊断和治疗特点。方法对中国人民解放军总医院自2012年1月至2023年9月收治的103例aPHPT患者的临床资料进行回顾性分析。分析了患者的临床特征、治疗模式和预后。使用 GraphPad Prism 8.0 软件进行统计分析。结果103 例患者中,男 37 例,女 66 例,年龄在 25 至 78 岁之间,平均年龄为(53.81±11.34)岁。98例(95.15%)因体检结果异常就诊,5例(4.85%)因高血压、糖尿病或其他疾病就诊。所有患者均接受了小切口微创甲状旁腺切除术,96例(93.20%)病理诊断为腺瘤,7例(6.80%)病理诊断为增生。术后平均血清钙、甲状旁腺激素(PTH)和碱性磷酸酶(ALP)水平分别显著低于术前水平,而术后血清磷水平显著高于术前水平(P3(范围0.05-49.50 cm3))。不同病灶体积的患者术前血清钙、PTH 和 ALP 水平差异显著。病变体积与术前血清钙呈正相关(ρ=0.36,PPP)。
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[The retrospective clinical study of asymptomatic primary hyperparathyroidism].

Objective: To summarize and analyze the diagnostic and therapeutic characteristics of asymptomatic primary hyperparathyroidism (aPHPT). Methods: A retrospective analysis was conducted on the clinical data of 103 patients with aPHPT admitted to the Chinese PLA General Hospital from January 2012 to September 2023. The clinical characteristics, treatment modes, and prognoses of the patients were analyzed. GraphPad Prism 8.0 software was used for statistical analysis. Results: Among the 103 cases, there were 37 males and 66 females, aged from 25 to 78 years, with an average age of (53.81±11.34) years. Ninety-eight cases (95.15%) visited due to abnormal findings during physical examination and 5 cases (4.85%) due to hypertension, diabetes or other diseases. All patients underwent minimally invasive parathyroidectomy with small incision, with 96 cases (93.20%) pathologically diagnosed as adenomas and 7 cases as hyperplasia (6.80%). Postoperative mean serum calcium, parathyroid hormone (PTH) and alkaline phosphatase (ALP) levels were respectively significantly lower than preoperative levels, while postoperative serum phosphorus level was significantly higher than preoperative level (P<0.05). The mean lesion volume was (3.32±6.72)cm3 (range 0.05-49.50 cm3). Patients with different lesion volumes had significant differences in preoperative serum calcium, PTH and ALP levels. Lesion volume was positively correlated to preoperative serum calcium(ρ=0.36, P<0.01), PTH(ρ=0.50, P<0.01) and ALP(ρ=0.39, P<0.01). Among 103 patients, 94 cases were followed up (91.26%), 9 cases were lost (8.74%), and the mean follow-up period was (60.15±29.23) months. The followed-up patients were alive and had no recurrence of lesions or complications, and their blood calcium levels were normal. Conclusion: aPHPT can be preliminarily diagnosed through blood biochemistry and imaging examination, and minimally invasive surgery can offer good prognosis without serious complications.

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