摘要
目的分析无症状型原发性甲状旁腺功能亢进症(primary hyperparathyroidism,PHPT)的临床和病理特征。方法回顾性分析2013年1月至2018年12月北京积水潭医院内分泌科及普通外科治疗的无症状型PHPT 30例和经典型PHPT 86例的临床特点和病理资料。无症状型PHPT男7例(23.3%),女23例(76.7%),男女比例1.0∶3.3;平均年龄(56.9±13.3)岁。经典型PHPT男32例(37.2%),女54例(62.8%);平均年龄(46.4±17.0)岁。骨代谢指标包括骨密度和骨生化标志物(甲状旁腺素、25羟维生素D和碱性磷酸酶)。采用t检验比较正态分布的计量资料,Mann-Whitney秩和检验比较偏态分布的计量资料,χ^(2)检验比较计数资料。结果无症状型PHPT血甲状旁腺素中位数144.2(108.1,207.0)pg/ml,血钙浓度平均(2.80±0.20)mmol/L,碱性磷酸酶中位数80.0(53.7,105.5)IU/L,均显著低于经典型组(P<0.05)。血25羟维生素D中位数12.14(7.87,14.38)ng/ml,高于经典型组(P<0.001)。无症状型10例(33.3%)发生骨质疏松,发生率低于经典型组(P<0.001)。无症状型肿瘤质量中位数0.80(0.25,1.98)g,小于经典型组(P=0.003),无症状型病理类型腺瘤26例(86.7%,其中非典型腺瘤2例),甲状旁腺增生4例(13.3%)。结论无症状型PHPT以女性为主,与经典型一致;平均年龄高于经典型。本研究中无症状型PHPT均为良性病变,骨生化指标异常,尤其是VitD缺乏普遍存在,同样可致骨质疏松。
Objective To analyze the clinical and pathological features of asymptomatic primary hyperparathyroidism(PHPT).Methods A retrospective analysis was carried out in terms of the clinical characteristics and pathological data in 30 patients with asymptomatic PHPT and 86 patients with typical PHPT hospitalized in the Department of Endocrinology and General Surgery of Beijing Jishuitan Hospital from Jan.2013 to Dec.2018.There were 7 males(23.3%)and 23 females(76.7%),with a male to female ratio of 1:3.3.The average age was 56.9±13.3 years.In typical PHPT group,there were 32 males(37.2%)and 54 females(62.8%),with the average age of 46.4±17.0 years.Bone metabolism indicators included bone density and bone biochemical markers(parathyroid hormone,25-hydroxyvitamin D and alkaline phosphatase).The t test was used to compare normally distributed variables,the Mann-Whitney rank sum test was used to compare skewed distributed variables,and theχ^(2) test was used to compare enumeration data.Results The median serum parathyroid hormone and alkaline phosphatase were 144.2(108.1,207.0)pg/ml and 80.0(53.7,105.5)IU/L respectively,the average serum concentration of calcium was 2.80±0.20 mmol/L,which were significantly lower than those of the classic group(P<0.05).The median serum 25-hydroxyvitamin D was 12.14(7.87,14.38)ng/ml,which was higher than that of the classic group(P<0.001).Ten patients(33.3%)developed osteoporosis,and the incidence was lower than that of the classic group(P<0.001).The median tumor weight was 0.80(0.25,1.98)g,significantly smaller than that in the classical group(P=0.003).There were 26 cases(86.7%,including 2 atypical parathyroid adenomas)of parathyroid adenomas and 4 cases(13.3%)of hyperplasia.Conclusions The asymptomatic PHPT has the same sex ratio as the classic type,mainly female,but the average age is significantly higher than that in the classic type.Although asymptomatic PHPT in this study are all benign lesions,abnormal bone biochemical indicators,especially vitamin D deficiency,are common,which also lead to osteoporosis.
作者
左庆瑶
崔爱民
王红
刘宝岳
王倩倩
邓微
Zuo Qingyao;Cui Aimin;Wang Hong;Liu Baoyue;Wang Qianqian;Deng Wei(Department of Endocrinology and Metabolism,Beijing Ji Shui Tan Hospital,Beijing 100035,China;Department of General Surgery,Beijing Ji Shui Tan Hospital,Beijing 100035,China;Department of Pathology,Beijing Ji Shui Tan Hospital,Beijing 100035,China;Beijing Institute of Traumatology and Orthopaedics,Beijing Ji Shui Tan Hospital,Beijing 100035,China)
出处
《中华内分泌外科杂志》
CAS
2022年第1期37-40,共4页
Chinese Journal of Endocrine Surgery
基金
人社部留学人员科技活动择优资助 (2015)。
