难治性继发性甲状旁腺功能亢进症患者术前碱性磷酸酶升高的危险因素  

Risk factors for preoperative alkaline phosphatase elevation in patients with refractory secondary hyperparathyroidism

作　　者：杨猛[1] 张凌[2] 黄林平[1] 刘军[1] 孙小亮[1] 纪浩洋[1] 鲁瑶[1] YANG Meng;ZHANG Ling;HUANG Linping;LIU Jun;SUN Xiaoliang;JI Haoyang;LU Yao(Department of General Surgery,China-Japan Friendship Hospital,Beijing 100029,China;Department of Nephrology,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院普通外科,北京100029 [2]中日友好医院肾病科,北京100029

出　　处：《重庆医学》2020年第4期554-556,560,共4页Chongqing medicine

摘　　要：目的探讨难治性继发性甲状旁腺功能亢进症(rSHPT)患者术前碱性磷酸酶(ALP)水平升高的危险因素。方法对2012年4月至2016年5月该院212例进行甲状旁腺全切除术(TPTX)的rSHPT患者进行了回顾性分析。结果共154例(72.6%)患者术前ALP升高。单因素分析显示,ALP升高组患者年龄明显小于ALP正常组[(45.41±11.00)岁vs.(50.17±11.80)岁,P=0.006]。术前甲状旁腺激素(PTH)在ALP升高组明显高于ALP正常组[(2116.82±848.14)pg/mL vs.(1041.09±118.12)pg/mL,P=0.000];术前Ca 2+在ALP升高组中显著低于ALP正常组[(2.59±0.27)mmol/L vs.(2.67±0.25)mmol/L,P=0.032]。Logistic回归分析显示,术前PTH升高是术前ALP升高的重要危险因素(P=0.000,Wald=35.960),其最佳截断点值为1634 pg/mL。结论术前PTH水平是预测rSHPT患者术前ALP升高的独立危险因素。Objective To determine predictors of preoperative elevation of alkaline phosphatase(ALP)in patients with refractory secondary hyperparathyroidism(rSHPT).Methods A retrospective analysis of 212 patients with rSHPT who underwent total parathyroidectomy without autotransplantation(TPTX)between April 2012 and May 2016 was performed.Results A total of 154(72.6%)patients had elevated ALP before surgery.Univariate analysis showed that patients with elevated ALP were significantly younger[(45.41±11.00)years vs.(50.17±11.8)years,P=0.006].Preoperative parathyroid hormone(PTH)levels were significantly elevated in the ALP-elevated group[(2116.82±848.14)pg/mL vs.(1041.09±118.12)pg/mL,P=0.000],and preoperative blood calcium level were lower than the ALP normal group[(2.59±0.27)mmol/L vs.(2.67±0.25)mmol/L,P=0.032].Logistic regression analysis showed that preoperative PTH elevation was an important risk factor for preoperative ALP elevation(P=0.000,Wald=35.960),with an optimal cut-off point of 1634 pg/mL.Conclusion The independent risk factor for predicting preoperative ALP elevation in patients with SHPT is preoperative PTH levels.

关 键 词：肾功能不全 碱性磷酸酶 甲状旁腺功能亢进症 

分 类 号：R653[医药卫生—外科学]