继发性甲状旁腺功能亢进症彩色多普勒超声学诊断意义及临床分析  

The significance of color Doppler ultrasonography in the diagnosis of secondary hyperparathyroidism: a clinical analysis

作　　者：周玉坤 李康峰 汤小芳 石平 张玉新 章亮 李冰 薛袁园 张美琪 赵学智[4] 

机构地区：[1]第二军医大学长征医院南京分院肾内科,南京210015 [2]第二军医大学长征医院南京分院超声科,南京210015 [3]第二军医大学长征医院南京分院检验科,南京210015 [4]解放军肾脏病研究所第二军医大学长征医院肾内科,上海200003

出　　处：《中国血液净化》2012年第7期365-368,共4页Chinese Journal of Blood Purification

摘　　要：目的 观察彩色多普勒超声探测维持性血液透析继发性甲状旁腺功能亢进症患者增殖腺体的数目及超声信号特点。方法 86例患者分为透析时间<8年组、透析时间≥8年两组。以彩色多普勒超声探测增殖腺体的数目、腺体的长、宽、厚以及腺体超声信号,计算腺体体积、记录血清学指标及超声图像。外科切除的腺体送病理检查。结果 不同透析时间的2组患者,增殖腺体的数目、腺体的体积、甲状旁腺激素水平及血磷存在统计学差异。透析时间<8年组甲状旁腺激素与增殖腺体的总体积之间无相关性,≥8年组甲状旁腺激素与增殖腺体的总体积之间存在相关性。病理检查示:腺体以节结节样增殖为主,主细胞及嗜酸性细胞均可见明显增殖。结论 以彩色多普勒超声行继发性甲状旁腺功能亢进腺体的筛查是一项简单有效的方法,同时也为下一步临床治疗提供依据。Objective To observe the number of proliferative parathyroid glands and the ultrasonic signal characteristics in hemodialysis patients with secondary hyperparathyroidism examined by color Doppler ultrasonography. Methods A total of 86 patients were divided into two groups: dialysis age <8 years group, and dialysis age≥ 8 years group. The number, length, width, thickness and volume of proliferative glands were evaluated by using color Doppler ultrasonography. Serum biochemical parameters and the color Doppler images were recorded. Surgically removed parathyroid glands were subjected to pathological examination. Results There were statistical differences in number and volume of proliferative glands, serum parathyroid hormone (PTH), and phosphorus levels between the dialysis age <8 years group and the dialysis age≥ 8 years group. The correlation between PTH level and the volume of proliferation glands was found in the dialysis age≥ 8 years group but not in the dialysis age <8 years group. Conclusions Color Doppler ultrasonography is a simple and effective method to detect proliferative parathyroid glands and to provide information about treatment approaches.

关 键 词：继发性甲状旁腺功能亢进症 彩色多普勒超声 腺体 增殖 甲状旁腺激素 

分 类 号：R69[医药卫生—泌尿科学]