中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2014年
3期
325-329
,共5页
甲状旁腺功能亢进症%高钙危象%帕米磷酸二钠
甲狀徬腺功能亢進癥%高鈣危象%帕米燐痠二鈉
갑상방선공능항진증%고개위상%파미린산이납
Primary hyperparathyroidism%Hypercalcemic crisis%Disodium pamidronate
目的 观察帕米磷酸二钠在治疗原发性甲状旁腺功能亢进症(PHPT)所导致的高钙危象中的降血钙作用.方法 因甲旁亢导致高钙危象共9人次、12例次,其中甲状旁腺癌4例、甲状旁腺腺瘤3例、甲状旁腺增生2例.12例次高钙危象治疗中均应用帕米磷酸二钠.对用药治疗前后的实验室数据进行统计分析.结果 (1)治疗前最高血钙水平3.75 (3.66、3.99) mmol/L治疗第2d血钙水平3.44 (2.95、3.78) mmol/L,第3d血钙水平2.79 (2.50、3.14) mmol/L,最低水平2.25 (2.00、2.55) mmol/L,各阶段血钙水平差异具有统计学意义(P＜0.05).治疗开始后第1个24h血钙下降幅度0.46 (0.10、0.88)mmol/L,第2个24 h血钙下降幅度0.60(0.25、0.75) mmol/L,两者比较差异无统计学意义(P＞0.05).(2)药物治疗后血总钙水平降至3.5 mmol/L以下所用时间为2～3d,(2.27±0.65)d.血总钙保持于3.5 mmol/L以下时间为4 ～40 d,(8.45±12.30)d.结论 帕米磷酸二纳在甲旁亢所引起的高钙危象治疗中可快速发挥降低血钙的作用,多可以在应用药物24 h左右明显降低血钙水平,并在治疗第2至第3天将血钙水平降至安全范围(＜3.5 mmol/L).
目的 觀察帕米燐痠二鈉在治療原髮性甲狀徬腺功能亢進癥(PHPT)所導緻的高鈣危象中的降血鈣作用.方法 因甲徬亢導緻高鈣危象共9人次、12例次,其中甲狀徬腺癌4例、甲狀徬腺腺瘤3例、甲狀徬腺增生2例.12例次高鈣危象治療中均應用帕米燐痠二鈉.對用藥治療前後的實驗室數據進行統計分析.結果 (1)治療前最高血鈣水平3.75 (3.66、3.99) mmol/L治療第2d血鈣水平3.44 (2.95、3.78) mmol/L,第3d血鈣水平2.79 (2.50、3.14) mmol/L,最低水平2.25 (2.00、2.55) mmol/L,各階段血鈣水平差異具有統計學意義(P＜0.05).治療開始後第1箇24h血鈣下降幅度0.46 (0.10、0.88)mmol/L,第2箇24 h血鈣下降幅度0.60(0.25、0.75) mmol/L,兩者比較差異無統計學意義(P＞0.05).(2)藥物治療後血總鈣水平降至3.5 mmol/L以下所用時間為2～3d,(2.27±0.65)d.血總鈣保持于3.5 mmol/L以下時間為4 ～40 d,(8.45±12.30)d.結論 帕米燐痠二納在甲徬亢所引起的高鈣危象治療中可快速髮揮降低血鈣的作用,多可以在應用藥物24 h左右明顯降低血鈣水平,併在治療第2至第3天將血鈣水平降至安全範圍(＜3.5 mmol/L).
목적 관찰파미린산이납재치료원발성갑상방선공능항진증(PHPT)소도치적고개위상중적강혈개작용.방법 인갑방항도치고개위상공9인차、12례차,기중갑상방선암4례、갑상방선선류3례、갑상방선증생2례.12례차고개위상치료중균응용파미린산이납.대용약치료전후적실험실수거진행통계분석.결과 (1)치료전최고혈개수평3.75 (3.66、3.99) mmol/L치료제2d혈개수평3.44 (2.95、3.78) mmol/L,제3d혈개수평2.79 (2.50、3.14) mmol/L,최저수평2.25 (2.00、2.55) mmol/L,각계단혈개수평차이구유통계학의의(P＜0.05).치료개시후제1개24h혈개하강폭도0.46 (0.10、0.88)mmol/L,제2개24 h혈개하강폭도0.60(0.25、0.75) mmol/L,량자비교차이무통계학의의(P＞0.05).(2)약물치료후혈총개수평강지3.5 mmol/L이하소용시간위2～3d,(2.27±0.65)d.혈총개보지우3.5 mmol/L이하시간위4 ～40 d,(8.45±12.30)d.결론 파미린산이납재갑방항소인기적고개위상치료중가쾌속발휘강저혈개적작용,다가이재응용약물24 h좌우명현강저혈개수평,병재치료제2지제3천장혈개수평강지안전범위(＜3.5 mmol/L).
Objective To study the efficacy of disodium pamidronate in the treatment of patients with primary hyperparathyroidism (PHPT) complicated by hypercalcemic crisis.Methods A total of 9 patients (12 cases) admitted into our hospital were diagnosed as PHPT complicated by hypercalcemic crisis.Of them,4 patients had parathyroid carcinoma,3 patients had parathyroid adenoma,2 patients had parathyroid hyperplasia.The intravenous disodium pamidronate was given for 12 times in all 9 patients.Serum calcium were monitored before and after treatment.Results Before the treatment,the serum calcium levels was 3.75 (3.66,3.99) mmol/L.On the second and third day after the treatment with disodium pamidronate,the serum calcium levels were 3.44 (2.95,3.78) mmol/L and 2.79 (2.50,3.14) mmol/L.The lowest level of serum calcium after treatment was 2.25 (2.00,2.55) mmoL/L.There were significant differences in the level of serum calcium of different days (P ＜ 0.05).On the second and third day,the change of serum calcium were 0.46 (0.10,0.88) mmol/L,0.60 (0.25,0.75) mmol/L,there were no differences.After intravenous disodium pamidronate,the serum calcium level decreased below 3.5 mmol/L in (2.27 ± 0.65) days,and were kept below 3.5mmol/L for 18.45 ± 12.30 days.Conclusions Disodium pamidronate can decrease serum calcium levels in hypercalcemic crisis caused by primary hyperparathyroidism effectively with mild adverse events.
