继发性甲状旁腺机能亢进的诊疗进展  

Treatment advance of secondary hyperthyroidism

作　　者：陈隽[1] 王家东[1] 

机构地区：[1]上海交通大学医学院附属仁济医院头颈外科,上海200001

出　　处：《山东大学耳鼻喉眼学报》2016年第2期36-39,共4页Journal of Otolaryngology and Ophthalmology of Shandong University

摘　　要：继发性甲状旁腺机能亢进(SHPT)是慢性肾功能不全(CKD)代谢紊乱所致的一类常见并发症,发病率逐年升高,临床表现为甲状旁腺激素(PTH)升高,伴有钙磷代谢紊乱、骨痛等症状。CKD继发甲状旁腺机能亢进的发病机制,除了熟知的因素(包括血钙血磷、维生素D及其受体、钙敏感受体等)以外,还涉及分子和细胞机制,如肽酰脯氨酰顺反异构酶1(Pin1)、抗衰老蛋白Klotho、成纤维细胞生长因子23等。目前治疗SHPT的主要方法有药物治疗、外科手术治疗和介入治疗,对手术治疗的术前定位和手术术式进行综述。Secondary hyperparathyroidism（ SHPT） is a common complication of metabolic disorders in chronic kidney disease（ CKD） patients. The Incidence of SHPT has increased with the passing years and the clinical manifestations are increased parathyroid hormone level,calcium-phosphorus metabolic disorders and bone pain,et al. In addition to the familiar factors,such as serum calcium and phosphorus,vitamin D and its receptor,calcium-sensing receptors,the mechanism for CKD-SHPT also includes the molecular and cellular mechanism,such as peptidyl-prolyl cis-trans isomerase 1（ Pin1）,Klotho protein and fibroblast growth factor-23（ FGF23）. Nowadays,the therapeutic strategy is mainly focused on medication,surgery and interventional therapy. This review will also introduce the pre-operation localization methods and surgical methods. It＇s critical to choose the suitable surgical methods for SHPT treatment.

关 键 词：继发性甲状旁腺功能亢进 治疗 定位 

分 类 号：R582.2[医药卫生—内分泌]