骨质疏松持续补钙导致高钙危象1例及文献复习  

A Case Study of Osteoporosis with Continuous Calcium Supplementation Leading to Hypercalcemia Crisis and Review of the Literatures

作　　者：侯立安[1] 宋桉[2] 王鸥[2] 丁文一[1] 徐二木[1] 刘茜[1] 夏良裕[1] HOU Li’an;SONG An;WANG Ou;DING Wenyi;XU Ermu;LIU Qian;XIA Liangyu(Department of Clinical Laboratory,Peking Union Medical College&Chinese Academy of Medical Science,Beijing 100730,China;Department of Endocrinology,Peking Union Medical College Hospital,Peking Union Medical College&Chinese Academy of Medical Science,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检验科,北京100730 [2]中国医学科学院北京协和医学院北京协和医院内分泌科,北京100730

出　　处：《标记免疫分析与临床》2023年第2期219-222,共4页Labeled Immunoassays and Clinical Medicine

基　　金：北京市临床重点专科医学检验科卓越项目(编号:ZK201000);首都卫生发展科研专项(编号:2020-1-4014)。

摘　　要：目的分析1例86岁女性患者高钙危象的实验室检验结果,分析高钙血症的病因,进一步为临床诊断提供参考依据。方法分析1例86岁高钙危象患者在疾病初期的实验室检查结果,以及停用钙剂2月后实验室检查结果,比较两次结果的变化,并分析变化产生的原因,助力临床对患者高钙血症病因的鉴别诊断。结果该患者首诊时因长期服用钙剂抑制了甲状旁腺素(parathyroid hormone,PTH)的分泌,PTH处于正常水平,停用钙剂后PTH异常升高。该患者最终诊断为原发性甲状旁腺功能亢进症(primary hyperparathyroidism,PHPT)。结论该患者高钙危象的原因为,在PHPT基础上,大剂量补充碳酸钙和骨化三醇,加重了高钙血症,产生呕吐症状,呕吐进一步加重血钙升高。Objective To analyze the laboratory test results of an 86-year-old female patient with hypercalcemic crisis,analyze the etiology of hypercalcemia,and to further provide a reference basis for the clinical diagnosis.Methods We analyzed the laboratory test results of an 86-year-old patient with hypercalcemia in the early stage of the disease and the laboratory test results after 2 months of calcium withdrawal.We then compared the changes in the two results and identified the reasons for the changes,leading to a better clinical diagnosis of the cause of hypercalcemia.Results At the time of the first visit,the patient’s parathyroid hormone(PTH)was at normal level due to long-term calcium suppression of PTH secretion,and PTH increased abnormally after calcium withdrawal.The patient was then diagnosed with Primary Hyperparathyroidism(PHPT).Conclusion The cause of hypercalcemia in this patient is high-dose supplementation of calcium carbonate and osteotriol on top of PHPT,which aggravates hypercalcemia and produces vomiting symptoms,and vomiting further aggravates the elevated blood calcium.

关 键 词：高钙血症 高钙危象 原发性甲状旁腺功能亢进 甲状旁腺素 

分 类 号：R582.1[医药卫生—内分泌]