山东大学耳鼻喉眼学报 ›› 2016, Vol. 30 ›› Issue (2): 36-39.doi: 10.6040/j.issn.1673-3770.1.2016.10

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继发性甲状旁腺机能亢进的诊疗进展

陈隽,王家东*   

  1. 上海交通大学医学院附属仁济医院头颈外科, 上海 200001
  • 收稿日期:2016-03-10 出版日期:2016-04-16 发布日期:2016-04-16

Treatment advance of secondary hyperthyroidism.

CHEN Jun, WANG Jiadong   

  1. Department of Otolaryngology, Renji Hospital Shanghai Jiaotong University School of Medicine, Shanghai 200001, China
  • Received:2016-03-10 Online:2016-04-16 Published:2016-04-16

摘要: 继发性甲状旁腺机能亢进(SHPT)是慢性肾功能不全(CKD)代谢紊乱所致的一类常见并发症,发病率逐年升高,临床表现为甲状旁腺激素(PTH)升高,伴有钙磷代谢紊乱、骨痛等症状。CKD继发甲状旁腺机能亢进的发病机制,除了熟知的因素(包括血钙血磷、维生素D及其受体、钙敏感受体等)以外,还涉及分子和细胞机制,如肽酰脯氨酰顺反异构酶1(Pin1)、抗衰老蛋白Klotho、成纤维细胞生长因子23等。目前治疗SHPT的主要方法有药物治疗、外科手术治疗和介入治疗,对手术治疗的术前定位和手术术式进行综述。

关键词: 继发性甲状旁腺功能亢进, 定位, 治疗

Abstract: Secondary hyperparathyroidism(SHPT)is a common complication of metabolic disorders in chronic kidney disease(CKD)patients. The Incidence of SHPT has increased with the passing years and the clinical manifestations are increased parathyroid hormone level, calcium-phosphorus metabolic disorders and bone pain, et al. In addition to the familiar factors, such as serum calcium and phosphorus, vitamin D and its receptor, calcium-sensing receptors, the mechanism for CKD-SHPT also includes the molecular and cellular mechanism, such as peptidyl-prolyl cis-trans isomerase 1(Pin1), Klotho protein and fibroblast growth factor-23(FGF23). Nowadays, the therapeutic strategy is mainly focused on medication, surgery and interventional therapy. This review will also introduce the pre-operation localization methods and surgical methods. Its critical to choose the suitable surgical methods for SHPT treatment.

Key words: Localization, Secondary hyperparathyroidism, Treatment

中图分类号: 

  • R582.2
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