【摘要】 目的分析不同病理类型甲状旁腺功能亢进(PHPT)的临床表现特点。方法回顾性分析1958—2005年北京协和医院收治经手术病理证实的280例PHPT患者的临床资料。按病理类型分为甲状旁腺腺瘤组208例,甲状旁腺增生组52例及甲状旁腺腺癌组20例。结果腺癌组中男性高于另外2组(P<0.05)。增生及腺癌组中骨畸形、骨软化比例较低,增生组骨吸收、病理性骨折比例低于腺瘤组;胃肠道症状、多饮多尿及泌尿系统病变在腺癌组中高于另外2组(P均<0.05)。血总钙(TCa)、血游离钙离子(ICa)及24h尿Ca在腺癌组显著高于腺瘤组及增生组(P均<0.01),在腺瘤组与增生组间差异无统计学意义(P>0.05)。出现高钙危象的比例在腺癌组显著高于另外2组(P<0.01)。腺癌组病灶重量高于增生组,腺瘤组病灶直径小于增生组(P均<0.05)。结论在本组病例中,腺癌组男性比例较高,泌尿系统病变更为多见,出现高钙危象的比例显著增高,术后复发的比例较高。增生组骨骼系统病变相对较轻,其病变甲状旁腺重量低于腺癌与腺瘤组。更多还原

【Abstract】 Objective To compare the clinical characteristics in primary hyperparathyroidism of different pathologic types through retrospective analysis of 280 cases diagnosed in PUMCH during 1958 to 2005.Methods Totally 280 patients were diagnosed as PHPT biochemically and proved by pathology.Serum PTH,TCa,P,25(OH)D,TRAP,plasma ICa,24 h urinary Ca and HOP were measured.Results M/F ratio was higher in carcinoma group(P<0.05).The rates of skeletal malformation and osteomalacia were lower in hyperplasia and carcinoma group;skeletal resorption and pathologic fracture were less frequent in hyperplasia group than in other two groups;symptoms of gastrointestinal tract,polydipsia,polyuria and changes in urinary system were more frequent in carcinoma group(P<0.05).Blood TCa,ICa and 24 h urinary calcium levels were significantly higher in carcinoma group(P<0.01)and similarly between adenoma and hyperplasia group.The rate of hypercalcemic crisis was higher in carcinoma group(P<0.01).The sizes of involved parathyroid gland(s)were smaller in hyperplasia group than in the other two groups(P<0.05).The recurrence rate was higher in carcinoma group.Conclusion In patients of parathyroid carcinoma;the ratio of M/F is higher,polydipsia,polyuria and changes in gastrointestinal or urinary system are more frequent;the serum and urinary calcium levels are higher;rate of hypercalcemic crisis and recurrence are much higher.The skeletal changes are less severe and sizes of involved gland(s)are smaller in hyperplasia group than in the other two groups.更多还原