特发性甲状旁腺功能减退症临床分析

目的 总结特发性甲状旁腺功能减退症(IHP)的临床特征.方法 回顾性分析1978年9月至2006年9月于北京协和医院内分泌科门诊就诊的53例IHP患者的临床表现及生化指标.结果 53例IHP患者血钙(1.54±0.23) mmol/L,血浆游离钙(0.70±0.14) mmol/L,血磷(2.1±0.4) mmol/L,甲状旁腺激素2.4(1～15.6) ng/L;各临床表现发生情况如下:手足搐搦为90.1％ (48/53),癫(癎)发作为41.5％ (22/53),智力减退为22.9％(11/48);白内障50.0％(12/24);颅内钙化42.5％(17/40).口服钙剂和维生素D制剂纠正低钙血症可以消除低血钙所造成的神经精神症状.结论 IHP是因甲状旁腺激素产生减少而引起的钙、磷代谢异常,长期口服钙剂和维生素D制剂可控制病情.

Clinical study on patients with idiopathic hypoparathyroidism

Objective To report the clinical manifestation, diagnosis and treatment of fifty-three patients with idiopathic hypoparathyroidism. Methods The clinical data of fifty-three patients with idiopathic hypoparathy- roidism admitted in Peking Union Medical College Hospital from 1978 to 2006 were retrospectively analyzed. Results The characteristic of biochemical index included hypocalcemia and hyperphosphatemia. The parathyroid hormone level was lower than the normal range. Tetany, epilepsy and neuropsychiatrial symptoms were common clin- ical manifestation of idiopathic hypoparathyroidism. After being treated with calcium and vitamin D, the neuropsy- chiatrial symptoms caused by hypocalcemia disappeared. Conclusions Idiopathic hypoparathyroidism is a metabol- ic disorder of calcium and phosphorus caused by parathyroid hormone insufficiency. The clinical manifestation of this disease includes hypocalcemia, tetany, epilepsy and neuropsychiatrial symptoms. Treatment with long-term calcium and vitamin I） can be effective.