自常规生化检验增加了钙测定之后,原发性甲状旁腺机能亢进(HPT)的检出率远比以前增多。此病的临床表现有肾石病或肾钙质沉着、非特异性胃肠道症状、近端肌肉无力及偶有精神症状。老年病人可有以神志改变为特征的急性高血钙危象,10%以下的病例可有骨病。高钙血症并不总是发生;血清磷酸盐浓度通常降低或为正常低值。甲状旁腺激素(PTH)浓度异常升高是确诊的依据,有症状的原发性HPT可用手术治疗,因为80％的患者为单纯性腺瘤所致,而那些无明显并发病者则可采用保守治疗。 Since routine biochemical tests increased the calcium test, the detection rate of primary hyperparathyroidism (HPT) is much higher than before. The clinical manifestations of this disease are nephrolithiasis or nephrocalcinosis, nonspecific gastrointestinal symptoms, proximal muscular weakness and occasional psychiatric symptoms. Elderly patients may have an acute hypercalcemia crisis characterized by a change of mind, and bone disease may occur in less than 10% of cases. Hypercalcaemia does not always occur; serum phosphate concentrations are usually reduced or are normally low values. An abnormal increase in parathyroid hormone (PTH) concentration is the basis of a definite diagnosis. Symptomatic primary HPT can be surgically treated because 80% of patients are caused by simple adenomas, while those with no apparent complication can be conservative treatment.