三发性甲状旁腺功能亢进症六例分析并文献复习  

Analysis on six cases of tertiary hyperparathyroidism and literature review

作　　者：贾爱华[1] 杜洪泉[2] 李玉红[1] 许俊龙[1] 张光珍[2] 

机构地区：[1]聊城市人民医院病理科,252000 [2]聊城市人民医院内分泌科,252000

出　　处：《中华内分泌代谢杂志》2013年第9期795-798,共4页Chinese Journal of Endocrinology and Metabolism

摘　　要：回顾分析三发性甲状旁腺功能亢进症患者6例。其中骨骼疼痛3例，双下肢无力1例，双下肢酸胀1例．碱性磷酸酶升高1例。既往有。肾衰竭史5例，另1例有严重肠道吸收障碍，其中行肾移植4例。x线显示骨膜下骨质吸收、骨质脱钙或伴纤维素性骨炎。骨密度示有骨质疏松5例，其中1例发生骨折。有2例出现骨外钙化，1例左房室膜钙化，1例臀部钙化。4例患者血钙升高，2例血钙正常，4例患者血磷下降，6例甲状旁腺素（PTH）均升高。术后甲状旁腺病理显示甲状旁腺腺瘤4例，增生2例。手术后6例患者血钙降低，补钙10～15d后恢复正常，PTH均恢复正常。The data of 6 patients with tertiary hyperparathyroidism were retrospectively analyzed. The first symptom in 3 patients was bone ache, 1 with lower extremity weakness, 1 with swelling of lower limbs, and 1 with increase serum alkaline phosphatase. 5 patients had past history of renal failure, 1 case suffered from severe intestinal malahsorption, and 4 of them had renal transplantation. X-ray showed subperiosteal hone resorption, hone demineralization, or cellulose osteitis. 5 subjects presented with osteoporosis, and 1 of them had fractures. Left atrioventricular membrane caMfication and gluteal calcification were found in each of 2 cases. 4 patients suffered from hypercalcaemia,2 patients with normal serum calcium, 4 with hypophosphataemia, and 6 with high levels of PTH. Pathological results showed adenoma in parathyroid gland in 4 patients and enlarged parathyroid glands in 2 patients. Serum calcium and PTH levels returned to normal after operation and calcium supplement.

关 键 词：发性甲状旁腺功能亢进症 甲状旁腺素 病理 

分 类 号：R582.1[医药卫生—内分泌]