河北医科大学学报

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同程度高钙血症患者病因分析

  

  1. 河北省沧州市中心医院内分泌科,河北 沧州 061014
  • 出版日期:2019-09-25 发布日期:2019-09-16
  • 作者简介:赵乃蕊(1985-),女,河北廊坊人,河北省沧州市中心医院主治医师,医学硕士,从事内分泌疾病诊治研究。

Etiological analysis of patients with different degrees of hypercalcemia#br#

  1. Department of Endocrinology, Cangzhou Central Hospital, Hebei Province, Cangzhou 061014, China
  • Online:2019-09-25 Published:2019-09-16

摘要: [摘要]
〖HTH〗目的〖HTSS〗〖KG*2〗探讨不同程度高钙血症患者的病因分布特点。
〖HTH〗方法〖HTSS〗〖KG*2〗回顾性分析58例高钙血症患者的临床资料,依据校正血钙水平分为轻度组22例、中度组15例、重度组21例,观察不同程度高钙血症的病因构成;比较原发性甲状旁腺功能亢进症(primary hyperparathyroidism,PHPT)和恶性肿瘤相关性高钙血症(malignancy associated hypercalcemia,MAH)的临床特点。
〖HTH〗结果〖HTSS〗〖KG*2〗高钙血症的病因多见于PHPT、MAH、甲状腺功能亢进、三发性甲状旁腺功能亢进。58例高钙血症患者中,PHPT 27例(46.55%),MAH 25例(43.10%),甲状腺功能亢进4例(6.90%),三发性甲状旁腺功能亢进2例(3.45%)。 重度高钙血症组MAH者较轻度高钙血症组多(P<0.05),甲状腺功能亢进在3组间差异有统计学意义(P<0.05),但两两比较差异无统计学意义(P>0.05)。将发生高钙血症最多的MAH与PHPT进行对比分析, MAH血白蛋白、甲状旁腺素水平低于PHPT,血磷、血肌酐高于PHPT, 差异均有统计学意义(P<0.05),MAH与PHPT碱性磷酸酶差异无统计学意义(P>0.05)。
〖HTH〗结论〖HTSS〗〖KG*2〗 高钙血症患者最常见病因为PHPT和MAH。MAH是重度高钙血症患者的主要病因。MAH 患者白蛋白、甲状旁腺素水平低,血肌酐水平高,生化指标的检测有助于临床诊治。

关键词: 高钙血症, 甲状旁腺功能亢进症, 甲状旁腺素

Abstract: [Abstract] Objective〖HTSS〗To investigate the etiological distribution of patients with different degrees of hypercalcemia.
〖HTH〗〖WTHZ〗Methods〖HTSS〗The clinical datas of 58 patients with hypercalcemia were analyzed retrospectively. According to the corrected serum calcium level, the patients were divided into mild hypercalcemia group(22 cases), moderate hypercalcemia group(15 cases)and severe hypercalcemia group(21 cases). The etiology distribution of different degrees of hypercalcemia was observed. The differences of the clinical characteristics between primary hyperparathyroidism(PHPT) and malignancy associated hypercalcemia(MAH) were compared.
〖HTH〗〖WTHZ〗Results〖HTSS〗The causes of high calcium levels were found in PHPT, MAH, thyroid function hyperfunction, tertiary hyperparathyroidism. Among the 58 patients with hypercalcemia, PHPT 27 cases(46.55%), MAH 25 cases(43.10%), hyperthyroidism 4 cases(6.90%) with triplex hyperparathyroidism 2 cases(3.45%)   were found. There were more MAH patients in the severe hypercalcemia group than in the mild hypercalcemia group, and the difference was statistically significant(P<0.05). There was a statistically significant difference in hyperthyroidism amony three groups(P<0.05), but no statistically significant difference between two groups(P>0.05). The MAH with the most hypercalcemia was compared with PHPT, and the MAH with lower serum albumin and parathyroid hormone levels than PHPT, higher serum phosphorus and serum creatinine than PHPT, with statistically significant differences(P<0.05) and no statistically significant differences between MAH and PHPT alkaline phosphatase(P>0.05).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗Hypercalcemia is most common in patients with PHPT and MAH. MAH is a major cause of severe hypercalcemia. MAH patients had low levels of albumin and parathyroid hormone and high levels of serum creatinine. The detection of biochemical indicators was helpful for clinical diagnosis and treatment.

Key words: hypercalcemia, phyperparathyroidism, parathyroid hormone