老年人原发性甲状旁腺功能亢进症临床特征分析

目的 比较老年与非老年患者原发性甲状旁腺功能亢进症(甲旁亢)的临床特点. 方法 回顾性分析58例原发甲旁亢患者的临床资料,按年龄分为老年组和非老年组,对两组患者临床资料进行分析. 结果 老年组20例,非老年组38例;与非老年组比较,老年组甲状旁腺激素((173.6±40.0)ng/L和(377.6±87.4)ng/L)、碱性磷酸酶(235.5±75.3)U/L和(517.8±84.1)U/L]等水平均较低;尿路结石(15%和42%)、骨骼疼痛(25%和50%)的发生率亦低于非老年组(P＜0.05).对手术确诊者的影像学资料进行分析,B超、CT(平扫或平扫加增强)、核素扫描检出的阳性率均较高,两组差异无统计学意义.术后老年组与非老年组患者的血钙水平较术前明显降低,有1例非老年组患者术后发生永久性低血钙. 结论 与非老年组比较,老年甲旁亢患者缺乏特异临床表现;手术治疗对于老年患者同样具有较高的有效性及安全性.

Clinical characteristics of primary hyperparathyroidism in the elderly people. YAN Shuang-tong,

Objective To compare the clinical characteristics of primary hyperparathyroidism between the senile patients and non-senile patients. Methods Fifty-eight cases with primary hyperparathyroidism hospitalized in our hospital between 1995 and 2007 were divided into the senile group (20 cases)and the control group (38 cases). The clinical data of the patients were analyzed retrospectively. Results Compared with the control group, the levels of parathyroid hormone (PTH) and alkaline phosphatase (ALP) were significantly lower and the incidences of bone pain and urinary calculus were markly reduced in the senile group (all P＜0.05). Ultrasonography, CT and nuclide scanning all had good diagnostic sensitivity for locating the affected parathyroid gland and there were no significantly differences between the two groups. The serum calcium level was significantly decreased after parathyroidectomy in both groups. Persistent hypocalcemia occurred only in one case in the control group after parathyroidectomy. Conclusions Compared with non-senile patients, primary hyperparathyroidism in senile patients often lacks specific clinical manifestations and surgical treatment is a sate and effective method.