甲状旁腺素测定预测甲状腺全切除术后低钙血症的价值

doi:10.3969/j.issn.1673-8640.2013.06.005

检验医学 ›› 2013, Vol. 28 ›› Issue (6): 475-478.DOI: 10.3969/j.issn.1673-8640.2013.06.005

甲状旁腺素测定预测甲状腺全切除术后低钙血症的价值

王田田¹,邵姗²,彭振兴³,徐先发⁴

1.北京大学民航临床医学院民航总医院耳鼻咽喉头颈外科，北京 100123；2.首都医科大学附属北京佑安医院耳鼻咽喉科，北京 100041

收稿日期:2012-04-20 修回日期:2012-12-17 出版日期:2013-06-30 发布日期:2013-06-11
通讯作者: 徐先发
作者简介:王田田，女，1988年生，硕士，主要从事头颈部肿瘤的临床和基础研究。

Predictive significance of parathyroid hormone determination in patients with hypocalcemia after total thyroidectomy

1. Department of Otolaryngology Head and Neck Surgery，Peking University Civil Aviation Clinical Medical College，Civil Aviation General Hospital，Beijing 100123，China； 2. Department of Otolaryngology，Beijing Youan Hospital，Capital Medical University，Beijing 100041，China

Received:2012-04-20 Revised:2012-12-17 Online:2013-06-30 Published:2013-06-11

摘要/Abstract

摘要： 目的　探讨甲状腺全切除术后血清1 h完整甲状旁腺素（1 h-iPTH）的测定在早期预测低钙血症中的临床价值。方法　103例甲状腺全切除患者于术后1及24 h分别检测血清1 h-iPTH及24 h校正血钙（24 h-cCa）。结果　103例甲状腺全切除患者术后低钙血症的发生率为37.9%（39/103），其中低钙血症患者1 h-iPTH水平显著低于血钙正常患者（P＜0.01）。术后1 h-iPTH＜16 pg/mL患者低钙血症的发生率显著高于1 h-iPTH≥16 pg/mL患者（P＜0.01）。以术后1 h-iPTH＜16 pg/mL作为术后低钙血症的预测指标，其敏感性、特异性和准确率分别为82.1%、90.6%和87.4%。结论　甲状腺全切除术后1 h-iPTH与术后低钙血症的发生存在较强的相关性，术后1 h-iPTH可以作为诊断低钙血症的指标。

关键词: 甲状旁腺素, 低钙血症, 甲状腺切除术

Abstract: Objective　To investigate the early predictive significance of serum 1 h intact parathyroid hormone（1h-iPTH）determination in patients with hypocalcemia after total thyroidectomy. Methods　A total of 103 patients undergoing total thyroidectomy were enrolled，and 1h-iPTH and serum 24 h corrected calcium（24h-cCa）levels were determined after total thyroidectomy 1 h and 24 h. Results　Among the 103 patients undergoing total thyroidectomy，the incidence of postoperative hypocalcemia was 37.9%（39/103），and the 1h-iPTH level in patients with hypocalcemia was lower than that in patients with normocalcemia（P＜0.01）. The incidence of hypocalcemia in patients with 1h-iPTH ＜16 pg/mL was higher than that in patients with 1 h-iPTH≥16 pg/mL（P＜0.01）. When 1h-iPTH＜16 pg/mL was as a predictor for hypocalcemia，the sensitivity，specificity and accuracy were 82.1%，90.6% and 87.4%，respectively. Conclusions　1h-iPTH after total thyroidectomy shows a strong correlation with postoperative hypocalcemia，and could be as an indicator for diagnosing hypocalcemia.

Key words: Parathyroid hormone, Hypocalcemia, Thyroidectomy

王田田1，邵姗2，彭振兴1，徐先发1. 甲状旁腺素测定预测甲状腺全切除术后低钙血症的价值[J]. 检验医学, 2013, 28(6): 475-478.

WANG Tiantian1，SHAO Shan2，PENG Zhenxing1，XU Xianfa1. Predictive significance of parathyroid hormone determination in patients with hypocalcemia after total thyroidectomy[J]. , 2013, 28(6): 475-478.

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甲状旁腺素测定预测甲状腺全切除术后低钙血症的价值

Predictive significance of parathyroid hormone determination in patients with hypocalcemia after total thyroidectomy

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