CAJ | 학술논문

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.
목적 비교노년여비노년환자원발성갑상방선공능항진증(갑방항)적림상특점. 방법 회고성분석58례원발갑방항환자적림상자료,안년령분위노년조화비노년조,대량조환자림상자료진행분석. 결과 노년조20례,비노년조38례;여비노년조비교,노년조갑상방선격소((173.6±40.0)ng/L화(377.6±87.4)ng/L)、감성린산매[(235.5±75.3)U/L화(517.8±84.1)U/L]등수평균교저;뇨로결석(15%화42%)、골격동통(25%화50%)적발생솔역저우비노년조(P＜0.05).대수술학진자적영상학자료진행분석,B초、CT(평소혹평소가증강)、핵소소묘검출적양성솔균교고,량조차이무통계학의의.술후노년조여비노년조환자적혈개수평교술전명현강저,유1례비노년조환자술후발생영구성저혈개. 결론 여비노년조비교,노년갑방항환자결핍특이림상표현;수술치료대우노년환자동양구유교고적유효성급안전성.
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.