甲状腺全切术后患者血清PTH水平变化及与PHC的关系  

Changes of serum PTH levels in the patients after thyroidectomy and its relationship with PHC

作　　者：陈志军 陈志兴 牛志国 鲁广恩 陈建 王栋 王永航 楼国新 王佳峰[2] 谭卓[2] 

机构地区：[1]浙江省东阳市横店文荣医院普外科,浙江东阳322118 [2]浙江省肿瘤医院普外科,浙江杭州310000

出　　处：《中国现代医生》2017年第18期5-8,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划(2014KYB038);浙江省金华市科技局项目(2016-4-043)

摘　　要：目的探讨甲状腺全切术后患者血清甲状旁腺激素(Parathyroid hormone,PTH)水平变化及与低钙血症(Post thyroidectomy hypocalcemia,PHC)的关系。方法选取2014年1月~2016年12月在我院甲状腺外科治疗的110例患者进行回顾性分析,根据患者一侧腺叶切除及同侧中央区淋巴结清扫结束后5~10 min血清PTH水平是否<10 pg/m L分为低PTH组68例和正常PTH组42例,对比两组术后不同时间点的血清PTH、血钙水平及PHC发生率。结果 T1、T2、T3、T4、T5时刻,两组患者的血清PTH水平、血钙离子较术前均降低(P<0.05);T3时刻,两组患者的PTH水平、血钙离子达到最低点,后逐渐升高;在T1、T2、T3、T4、T5时刻,正常PTH组的PTH水平、血钙离子高于低PTH组(P<0.05);低PTH组在手术后7 d内PHC发生率为64.71%,高于正常PTH组的26.19%,差异具有统计学意义(P<0.05);选取术后第3天的血清PTH水平与血钙离子水平进行相关分析,结果显示PTH与PHC呈显著的正相关关系(r=0.629,P<0.001)。结论甲状腺全切术后患者血清PTH水平会出现降低,同时与患者的血清钙离子水平降低有关系。Objective To investigate the changes of serum parathyroid hormone（PTH） levels in patients after thyroidec- tomy and its relationship with post thyroidectomy hypocalcemia （PHC）. Methods A total of 110 patients in the Depart- ment of Thyroid Surgery in our hospital from January 2014 to December 2016 were selected and retrospectively ana- lyzed. According to whether the serum PTH level was 〈10 pg/mL 5-10 minutes after the end of unilateral lobectomy and ipsilateral central lymph node dissection, the patients were divided into low PTH group of 68 patients and normal PTH group of 42 patients. The levels of serum PTH, serum calcium and PHC incidence rate were compared between the two groups at different time points after the surgery. Results The levels of serum PTH and calcium in both groups were lower than those before the surgery at T1, T2, T3, T4 and T5 （P〈0.05）. At T3, the PTH level and calcium reached the lowest point in both groups, then gradually increased; at T1, T2, T3, T4 and T5, the PTH level and calcium level in the normal PTH group were higher than those in low PTH group （P〈0.05）; the incidence rate of PHC within 7 days after the surgery in the low PTH group was 64.71%, higher than that of 26.19% in the normal PTH group, and the difference was statistically significant（P〈0.05）; the correlation between serum PTH level and the serum calcium level on the third day after the surgery was analyzed, and the results showed a significant positive correlation between PTH and PHC （r= 0.629, P〈0.001）. Conclusion The level of serum PTH in patients receiving thyroidectomy is decreased, and it is related to the decrease of serum calcium level.

关 键 词：甲状腺全切 甲状旁腺激素 低钙血症 血钙 

分 类 号：R736.1[医药卫生—肿瘤]