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目的 研究肾性甲状旁腺功能亢进（甲旁亢）患者甲状旁腺组织钙敏感受体（ＣａＲ）的表达，探讨ＣａＲ在肾性甲旁亢发病机制中的作用。方法用免疫组织化学的方法，比较正常对照组和继发性甲旁亢（ＳＨＰＴ）组甲状旁腺ＣａＲ蛋白质的表达。结果ＣａＲ在正常甲状旁腺组织的细胞膜和细胞浆均有表达，细胞阳性率为（７５．２０±２．３１）％，而ＳＨＰＴ组为（２７． ８８ ± ４． ９０）％，明显减少（Ｐ＜０．０１）。弥漫性增生和结节性增生之间差异也有显著性［分别为（４０ ．００ ±３． ３４）％和 （１５． ７５±１．７５）％，Ｐ＜０． ０１］。ＣａＲ表达阳性率与腺体重量呈负相关（ｒ＝－０．８６，Ｐ＜０．０１）。结论严重肾性甲旁亢患者甲状旁腺ＣａＲ表达明显下降，结节性增生比弥漫性增生下降更显著，是引起ＰＴＨ过度分泌的重要原因。上调ＣａＲ的表达或激活ＣａＲ的功能将成为肾胜甲旁亢新的治疗目标。
Objective To investigate the expression of CaR in parathyroid tissue in patients with renal hyperparathyroidism (hyperparathyroidism) and to explore the role of CaR in the pathogenesis of renal hyperparathyroidism. Methods The expression of CaR protein in parathyroid glands of normal control group and secondary hyperparathyroidism (SHPT) group was compared by immunohistochemistry. Results The expression of CaR was detected in the cell membrane and cytoplasm of normal parathyroid tissue. The positive rate of CaR was (75.20 ± 2.31)%, while it was (27.88 ± 4.90)% in SHPT group P <0.01). There was also a significant difference between diffuse hyperplasia and nodular hyperplasia [(40 .00 ± 3.34)% and (15,75 ± 1.75)%, respectively, P <0. 01]. The positive rate of CaR expression was negatively correlated with gland weight (r = -0.86, P <0.01). Conclusions The expression of CaR in parathyroid glands of patients with severe renal hyperparathyroidism is significantly decreased, and nodular hyperplasia is more significant than that of diffuse hyperplasia, which is an important reason for the over-secretion of PTH. Upregulation of CaR expression or activation of CaR function will become a new therapeutic goal of kidney bypass hyperparathyroidism.