摘要
Abstract
Objective To examine the clinical features of primary hyperparathyroidism ( PHPT ) . Methods We enrolled 84 patients with PHPT who were admitted into Beijing Shijitan Hospital from January 2010 to April 2014. Retrospective analyses were conducted on the general data, clinical manifestation, physical examination, laboratory inspection, imaging examination and pathological examination of the subjects. Results ( 1 ) We collected 5,4,12,39 and 24 subjects respectively in 2010,2011,2012,2013 and 2014. (2)Among 84 subjects,18 were males and 66 were females;the ages of onset were within 19-79 with an mean of ( 54. 2 ± 1. 6 );the ages of diagnose were within 23 -84 with an mean of ( 58. 0 ±1. 6);the course of disease ranged from 7 days to 30 years with median of 1. 75 years. (3)The number of subjects with adenoma was 54(64. 3%),among which 34 were with single adenoma and 20 were with multiple adenomas;the number of subjects with hyperplasia was 17 ( 20. 2%), among which 3 were with single adenoma and 14 were with multiple adenomas;there were 13 subjects(15. 5%)with adenocarcinoma. (4)For the initial symptoms,there were 11 subjects(13. 1%)who were asymptomatic initially,41 subjects(48. 8%)with bone symptoms,14 subjects(16. 7%)with renal symptoms,7 subjects(8. 3%)with both bone and renal symptoms,11 subjects(13. 1%)with hypercalcemia symptoms,5 subjects (6. 0%)with symptoms relevant with neuromuscular system and 6 subjects(7. 1%)with symptoms relevant with digestive system. The subjects with different initial symptoms were significantly different(P<0. 05)in the age of onset and gender. (5) For the clinical manifestations, there were 7 subjects ( 8. 3%) who were asymptomatic, 76 subjects ( 90. 5%) with hypercalcemia symptoms,30 subjects(39. 5%)with symptoms relevant with digestive system,33 subjects(43. 4%)with relevant with neuromuscular system, 13 subjects ( 17. 1%) with symptoms relevant with circulatory system, 66 subjects (78. 6%)with bone symptoms and 35 subjects ( 41. 7%) with renal symptoms. ( 6 ) Serum PTH increased by 100. 0%(84/84),24 h urine phosphorus increased by 84. 8%(28/33),serum phosphate decreased by 54. 8%(46/84),blood calcium increased by 52. 4%(44/84),24 h urinary calcium increased by 51. 5%(17/33),ALP increased by 47. 5%(38/80),blood chlorine increased by 29. 3%(24/82),serum creatinine increased by 9. 8% (8/82) and serum magnesium decreased by 4. 9%(4/82). Conclusion PHPT patients show an increasing trend,with high age of onset and long disease course. The pathological type is primarily adenoma, and the incidence of adenocarcinoma has been increasing. The initial symptoms are diversified, with the hypercalcemia and bone symptoms as the major clinical manifestations. The changes in laboratory indicators are evident,which is the common and typical feature of PHPT.关键词
甲状旁腺功能亢进,原发性/临床特征/回顾性研究Key words
Hyperparathyroidism,primary/Clinical features/Retrospective studies分类
医药卫生
