甲状旁腺切除术对终末期肾脏疾病患者冠状动脉钙化的影响

目的 评价甲状旁腺切除术(PTX)对终末期肾脏疾病(ESRD)患者冠状动脉钙化(CAC)的影响.方法 收集2008年1月至2009年5月我院30例行PTX的ESRD患者资料,对患者进行多层螺旋CT扫描,再根据Agaston方法计算CAC积分,比较存在CAC者手术前、后CAC积分.比较患者手术前、后甲状旁腺素、血钙、血磷...

Effect of parathyroidectomy on coronary artery calcification of patient with end-stage renal diseases

Objective To evaluate the effect of parathyroidectomy （PTX） on coronary artery calcification （CAC） and calcium and phosphate abnormality of patients with end-stage renal diseases （ESRD）. Methods Thirty ESRD patients with severe secondary hyperparathyroidism （SHPT） who underwent PTX in our division were enrolled in this study. Multislice spiral computed tomography （MSCT） was done, and CAC score was calculated by Agaston method. Parathyroid hormone （PTH）, serum calcium and phosphate, and CAC score were recorded before and 6, 12 months after PTX. Meanwhile, clinical symptoms and negative symptoms of PTX were also evaluated. Results Serum calcium and phosphate, the product of calcium and phosphate, and PTH were decreased gradually 6, 12 months after PTX as compared with those before PTX. Concomitantly, the CAC was gradually reduced from 6 months after PTX. Symptoms such as the skin pruritus, bone-arthrosis pain, restless legs syndrome and insomnia were improved significantly after PTX. There was no significant serious negative symptom. Conclusions PTX can reduce the PTH level and correct calcium and phosphate abnormality safely and effectively. It can prevent or reverse progression of CAC.