甲状旁腺功能减退症和假性甲状旁腺功能减退症心血管系统表现  

Cardiovascular manifestations of hypoparathyroidism and pseudohypoparathyroidism

作　　者：王亚冰 王鸥 邢小平 WANG Ya-bing;WANG Ou;XING Xiao-ping(Department of Endocrinology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Key Laboratory of Endocrinology of National Health Commission of the People s Republic of China,Beijing 100730,China)

机构地区：[1]中国医学科学院,北京协和医学院,北京协和医院内分泌科,国家卫生和健康委员会内分泌重点实验室,北京100730

出　　处：《中华骨质疏松和骨矿盐疾病杂志》2020年第2期164-171,共8页Chinese Journal Of Osteoporosis And Bone Mineral Research

基　　金：国家自然科学基金面上项目(81270873,81873641)。

摘　　要：甲状旁腺功能减退症(hypoparathyroidism,HP)和假性甲状旁腺功能减退症(pseudohypoparathyroidism,PHP)均以低钙血症、高磷血症为主要生化特征,前者甲状旁腺素(parathyroid hormone,PTH)减低或不适当的正常,后者PTH水平升高,这些生化指标异常均可能对心血管系统产生不利影响。急性严重低钙血症在HP和PHP患者会造成心脏结构和功能异常,急性和慢性低钙血症还会引起心脏传导异常。研究发现HP患者动脉粥样硬化和冠状动脉钙化的风险增加;而PHP患者可能出现高血压、肥胖和糖代谢异常。已有单中心研究发现非术后HP患者死亡和心血管事件发生风险增加。因目前研究数量有限,尚需进一步研究以探索HP和PHP对心血管系统的影响及其机制和可能风险。Hypoparathyroidism and pseudohypoparathyroidism are characterized by hypocalcemia and hyperphosphatemia,with decreased or inappropriately normal parathyroid hormone in the former,and increased parathyroid hormone in the latter.These biochemical abnormalities may have adverse effects on the cardiovascular system.Acute and severe hypocalcemia in patients with hypoparathyroidism and pseudohypoparathyroidism can cause cardiac structure and function abnormalities,and acute and chronic hypocalcemia can also cause cardiac conduction abnormalities.Studies found that the risk of atherosclerosis and coronary artery calcification was increased in patients with hypoparathyroidism.Patients with pseudohypoparathyroidism may have hypertension,obesity,and abnormal glucose metabolism.Single-center study has found an increased risk of death and cardiovascular events in patients with non-surgical hypoparathyroidism.Due to the limited studies,further studies are needed to explore the effects of hypoparathyroidism and pseudohypoparathyroidism on the cardiovascular system,as well as their mechanisms and possible risks.

关 键 词：甲状旁腺功能减退症 假性甲状旁腺功能减退症 心血管 代谢 

分 类 号：R582[医药卫生—内分泌]