原发性甲状旁腺功能亢进患者胃肠道病理

I. A. Baranova, A. V. Baranov
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引用次数: 0

摘要

的目标。介绍国内外关于原发性甲状旁腺功能亢进(PHPT)患者胃肠道(GIT)病理的患病率、发病机制及临床资料。关键。在20世纪初,PHPT被认为是一种严重的内分泌疾病,伴有特定的骨骼和肾脏并发症,然而在1957年,W.T. St Goar提出了一种记忆三联症,将这种病理识别为“结石、骨骼和腹部呻吟的疾病”。据报道,PHPT患者的胃肠道主诉、消化性溃疡、胰腺炎、胆石症的发生率很高。甲状旁腺功能亢进已被证明会引起平滑肌张力失调,并伴有特定的上消化道和下消化道症状,如恶心、胃灼热和便秘。根据上世纪50 - 60年代的研究,PHPT患者中消化性溃疡的患病率从10%到25%不等。然而,将PHPT与消化性溃疡发展联系起来的研究是在质子(1)出现之前进行的。另一方面,PHPT中胰腺炎的发展是研究最多的病理之一。在发展中国家,由于缺乏血钙常规筛查,其发病率可达10 - 20%。一些作者报道了甲状旁腺激素水平升高通过抑制胆囊排空、肝胆汁分泌和Oddi括约肌的运动以及改变胆汁成分对胆囊结石形成的影响。许多研究发现,phpt患者发生肠道恶性肿瘤的风险增加,尤其是结肠恶性肿瘤。甲状旁腺功能障碍患者的消化表现常被忽视,在出现腹部症状时应将血钙水平纳入常规检查。
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Pathology of the Gastrointestinal Tract in Patients with Primary Hyperparathyroidism
Aim. To present data of Russian and foreign studies on the prevalence, pathogenesis and clinical picture of gastrointestinal tract (GIT) pathology in patients with primary hyperparathyroidism (PHPT).Key point. At the beginning of the 20th century PHPT was considered a severe endocrine disease with specific bone and kidney complications, however in 1957 W.T. St Goar proposed a mnemonic triad to recognize this pathology as “diseases of stones, bones and abdominal groans”. A high frequency of gastrointestinal complaints, peptic ulcer, pancreatitis, cholelithiasis in patients with PHPT has been reported. Hyperparathyroidism has been shown to cause smooth muscle atony with specific upper and lower GI symptoms such as nausea, heartburn and constipation. The prevalence of peptic ulcer in patients with PHPT, according to studies of the 50s–60s of the last century, ranged from 10 to 25 %. However, studies linking PHPT to peptic ulcer development were performed before the advent of proton 1). On the other hand, the development of pancreatitis in PHPT is one of the most studied pathologies. In developing countries its frequency can reach 10–20 % due to the absence of routine screening for blood calcium. Some authors report the impact of elevated parathyroid hormone levels on the formation of gallbladder stones by inhibiting of gallbladder emptying, hepatic bile secretion and mobility of the sphincter Oddi, and changing of the bile composition. A number of studies have found an increased risk of developing malignant neoplasms of the intestine, especially the colon, in patients with PHPT.Conclusion. The digestive manifestations of parathyroid dysfunction in patients can often be overlooked, and serum calcium levels should be included in the routine examination in the presence of abdominal symptoms.
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CiteScore
1.90
自引率
0.00%
发文量
44
审稿时长
8 weeks
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