甲状腺术后PTH及Ca水平对症状性低血钙的预测价值  

Predictive value of PTH and Ca level for symptomatic hypocalcemia after thyroid operation

作　　者：娄国平[1] 李显东[1] 张昭勇[1] 曹政[2] 

机构地区：[1]十堰市太和医院检验科,湖北十堰442000 [2]湖北医药学院心内科

出　　处：《西南国防医药》2015年第2期119-122,共4页Medical Journal of National Defending Forces in Southwest China

基　　金：湖北省教育厅2011年度科研项目计划(Q20112101)

摘　　要：目的观察甲状腺术后血清甲状旁腺素（PTH）及Ca水平与患者症状性低钙血症发生之间关系,并探讨其预测价值。方法选择本院于2011年1月～2013年12月收治的需行甲状腺全切除术患者180例作为研究对象,男67例,女113例,观察术后1、12、24 h的血清Ca及PTH水平,统计术后症状性低钙血症发生率,分析术后血清Ca及PTH水平与症状性低钙血症发生之间的关系。结果本组180例中,术后出现症状性低钙血症67例,发生率为37.2%;术后血清钙浓度〈2.2mmol/L患者有75例,其中出现症状性低钙血症64例（85.3%）,而术后血钙正常患者105例,出现症状性低钙血症仅3例（2.9%）（P〈0.05）。术后PTH〈1.48 pmol/L患者共77例,出现症状性低钙血症61例（79.2%）,而PTH〉1.48 pmol/L患者103例,出现症状性低钙血症仅6例（5.9%）（P〈0.05）。结论甲状腺术后血清PTH及Ca水平与患者症状性低钙血症发生具有相关性,监测术后血清PTH及Ca水平具有重要临床预测价值。Objective To observe the relation of serum parathyroid hormone （PTH） and serum calcium （Ca） level with the incidence of symptomatic hypocalcemia in the patients after thyroid operation and explore the predictive value. Methods Total 180 patients to receive thyroid operation in our hospital from Jan. 2011 to Dec. 2013 were selected as research subjects（ male n = 67 ,female n = 113 ） ;the serum Ca and PTH levels one hour, 12 hours, and 24 hours after the operation were measured, statistics of the incidences of postoperative symptomatic hypocalcemia was made, and the relationship between the postoperative serum Ca and PTH levels and symptomatic hypocalcemia was analyzed. Results In 180 cases,postoperative symptomatic hypocalcemia occurred in 67 cases,with an incidence of 37.2% ;the postoperative serum calcium concentration was less than 2.2 mmol/L in 75 cases, including 64 ones （85.3 % ） with symptomatic hypocalcemia,while postoperative serum calcium concentration was normal in 105 cases, including 3 ones （2.9%） with symptomatic hypocalcemia （P 〈 0.05 ）. After the operation, PTH of 77 cases was less than 1.48 pmol/L including 61 ones （79.2%）with symptomatic hypocalcemia and 103 ones was larger than 1.48 pmol/L including six ones（5.9% ）with symptomatic hypocalcemia（P 〈 0.05 ）. Conclusion The postoperative serum PTH and Ca levels after thyroid operation have correlation with the incidence of symptomatic hypocalcemia, so monitoring of postoperative serum PTH and Ca levels has significant predictive value for clinical use.

关 键 词：甲状腺 甲状旁腺素 血钙 低钙血症 术后 预测 

分 类 号：R581[医药卫生—内分泌]