论文部分内容阅读
目的:回顾性分析1958年至2005年12月北京协和医院收治的280例原发性甲状旁腺功能亢进症(PHPT)患者的临床资料,比较北京地区与纽约地区收治的PHPT临床表现的不同。方法:280例PHPT患者均经手术病理证实,术前测定血清甲状旁腺激素(PTH)、总钙(TCa)、磷(P)、血浆游离钙(ICa)、24h尿Ca、血清25(OH)D3水平,并与纽约地区1984年至1999年PHPT患者资料作比较。结果:我院PHPT患者年龄较小;在临床表现方面,骨骼系统病变的比例较高;纽约地区患者单纯泌尿系统结石及单纯高钙血症的比例较高;我院患者血Ca、PTH水平升高更为明显,血P水平降低,AKP水平升高及24h尿Ca水平升高的比例更高,血清25(OH)D3水平较低;我院患者甲状旁腺癌比例较高(P值均<0.05)。结论:北京地区PHPT临床表型与纽约地区有显著差异,且其PHPT患者发病年龄较小,临床症状更为突出,生化改变更为明显,腺癌比例较高,病变甲状旁腺的体积也较大。
OBJECTIVE: To retrospectively analyze the clinical data of 280 patients with primary hyperparathyroidism (PHPT) admitted from Peking Union Medical College Hospital from December 1958 to December 2005 and compare the clinical manifestations of PHPT admitted between Beijing and New York. Methods: Two hundred and seventy PHPT patients were confirmed by surgery and pathology. Preoperative serum PTH, TCa, P, ICa, 24h urinary Ca, serum 25 (OH ) D3 levels were compared with those of PHPT patients in New York from 1984 to 1999. Results: The age of PHPT patients in our hospital was relatively small. In terms of clinical manifestations, the proportion of patients with skeletal system diseases was higher. The proportion of patients with simple urinary system stones and hypercalcemia alone was higher in New York area. The levels of Ca, PTH High and more obvious, lower blood P levels, AKP levels and increased levels of urinary calcium 24h higher proportion of serum 25 (OH) D3 levels lower; patients with parathyroid cancer in our hospital a higher proportion of (P value <0.05). Conclusion: The clinical phenotypes of PHPT in Beijing are significantly different from those in New York area. The age of onset of PHPT patients is younger, the clinical symptoms are more prominent, the biochemical changes are more obvious, the proportion of adenocarcinoma is higher, the volume of pathological parathyroid glands is also more Big.