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特发性甲状旁腺功能减退症(特发性甲旁减)国内报道较多,一般临床表现、诊断治疗已有详尽阐述。本文报道本症8例,其临床表现、生化检查及治疗均有其特殊之处;如合并Klinefelter氏综合征,先有角质下脓疱病后发生本症,由于严重癫痫用大量抗癫痫药诱发全身剥胶性皮炎、CPK及LDH明显升高等国内尚未见报告。本组血钙最低为2.4mg/dl,血磷最高达11.7mg/dl,亦为文献中之极限值。治疗方面3例作了甲状旁腺移植术;1例为狗甲状旁腺埋藏,2例为带血管甲状分腺移植。 癫痫及癔症样发作可为四旁减之表现。故遇上述病人应除外甲旁减之可能。本文对临床常用甲状旁腺功能如磷廓清、肾小管磷重吸收率及钙耐量试验进行了评价,认为临床表现生化结果均典型病人,巳无必要再行上述试验。亚临床期甲旁减是否能赖上述试验而获早期诊断有待观察。 本文最后对甲状旁腺移植进行了讨论,认为带血管移植为治疗甲旁减之有效措施。1例狗甲状旁腺埋藏,效果奇特,其机制值得进一步探讨。
Idiopathic hypoparathyroidism (idiopathic hypoparathyroidism) more domestic reports, the general clinical manifestations, diagnosis and treatment have been elaborate. This article reports 8 cases of this disease, its clinical manifestations, biochemical tests and treatment have their own special features; such as the merger of Klinefelter’s syndrome, the first occurrence of the disease after keratinized impetigo, due to severe epilepsy induced by a large number of antiepileptic drugs Whole body peel gum dermatitis, CPK and LDH was significantly higher in China and other reports have not been reported. The lowest serum calcium of 2.4mg / dl, serum phosphorus up to 11.7mg / dl, also the literature limit. Three cases of treatment for parathyroid transplantation; 1 case of the dog buried in the parathyroid, 2 cases of vascular thyroid gland transplantation. Epilepsy and hysteria-like episodes may be reduced on all sides of the performance. Therefore, the case of patients should be excluded in addition to the possibility of a bypass. In this paper, commonly used clinical parathyroid function such as phosphorus clearance, renal tubular phosphorus reabsorption and calcium tolerance test was evaluated that the clinical manifestations of biochemical results are typical patients, have no need to repeat the above test. Subclinical hypothyroidism can rely on the above tests and early diagnosis remains to be seen. Finally, this article discusses the parathyroid transplantation, and considers that vascular graft is an effective treatment for parathyroidism. A case of dog parathyroid glands buried, the effect is peculiar, the mechanism worth further study.