原发性甲状旁腺功能亢进症与甲状腺疾病的关系探讨

doi:10.3969/j.issn.1006-7795.2017.03.022

首都医科大学学报 ›› 2017, Vol. 38 ›› Issue (3): 446-450.doi: 10.3969/j.issn.1006-7795.2017.03.022

原发性甲状旁腺功能亢进症与甲状腺疾病的关系探讨

修磊, 姜涛, 傅月玥

首都医科大学附属北京世纪坛医院内分泌科, 北京 100038

收稿日期:2016-10-14 出版日期:2017-05-21 发布日期:2017-06-14
通讯作者: 姜涛 E-mail:jiangtao960@126.com
基金资助:
中国铁路总公司科技研究开发计划课题（J2016Z029）。

Analysis of relationship between primary hyperparathyroidism and thyroid diseases

Xiu Lei, Jiang Tao, Fu Yueyue

Department of Endocrinology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China

Received:2016-10-14 Online:2017-05-21 Published:2017-06-14
Supported by:
This study was supported by Scientific and Technological Research and Development Plan of China Railway Corporation (J2016Z029).

摘要/Abstract

摘要： 目的分析原发性甲状旁腺功能亢进症（primary hyperparathyroidism，PHPT）病人伴发甲状腺病变的发病情况，探讨PHPT与甲状腺疾病的关系。方法回顾分析84例PHPT病人资料，统计PHPT合并甲状腺病变的详细发病情况及PHPT对病人甲状腺功能的影响，使用SPSS统计软件分析PHPT与甲状腺疾病的相关性以及PHPT对病人甲状腺功能的影响。结果本组PHPT病例合并甲状腺疾病主要为结节性甲状腺肿（62/74），其中单发结节性甲状腺肿25例（33.8%），多发结节为37例（50.0%），甲状腺髄样癌（medullary thyroid carcinoma，MTC）病人12例（16.2%）。PHPT病人总T4（total tetraiodothyronine，TT4）及游离T4（free tetraiodothyronine，FT4）浓度较正常成年人降低（P<0.05）。TT4及FT4均与甲状旁腺激素（serum parathyroid hormone，PTH）浓度呈负相关（P<0.05）。结论 PHPT病人甲状腺疾病高发，且TT4及FT4浓度较正常成年人降低，其原因可能与高PTH相关。

关键词: 原发性甲状旁腺功能亢进症, 甲状腺结节, 甲状腺髓样癌, 甲状旁腺激素

Abstract: Objective In order to investigate the occurrence of thyroid diseases in primary hyperparathyroidism (PHPT), and analyze the relationship between them. Methods We collected 84 admission cases which were diagnosed as PHPT from 2010 to 2014 in Beijing Shijitan Hospital of the Capital Medical University. Then we analyzed the morbidity of concomitant thyroid diseases and thyroid function. Results Totally 84 cases were diagnosed as PHPT both by surgical and pathological diagnosis. The largest thyroid disease was nodular goiter (62/74),which included 25 single thyroid nodule (33.8%),37 multiple thyroid nodules (50.0%). Besides, 12 cases accompanied medullary thyroid carcinoma (16.2%). Patients with PHPT had low level of total tetraiodothyronine (TT4) and free tetraiodothyronine (FT4)(P<0.05). TT4 and FT4 negatively correlated with serum parathyroid hormone (PTH) (P<0.05). Conclusion Concomitant thyroid diseases in patients with PHPT are arresting. Patients with PHPT have low level of TT4 and FT4, which may be closely related to PTH. We recommend the routine use of ultrasound in patients with PHPT to detect any concomitant thyroid diseases and thus determine the best surgical strategy.

Key words: primary hyperparathyroidism(PTH), thyroid nodule, medullary thyroid carcinoma(MTC), parathyroid hormone(PTH)

中图分类号:

修磊, 姜涛, 傅月玥. 原发性甲状旁腺功能亢进症与甲状腺疾病的关系探讨[J]. 首都医科大学学报, 2017, 38(3): 446-450.

Xiu Lei, Jiang Tao, Fu Yueyue. Analysis of relationship between primary hyperparathyroidism and thyroid diseases[J]. Journal of Capital Medical University, 2017, 38(3): 446-450.

参考文献

[1] Polyzos S A, Anastasilakis A D, Iakovou I P, et al. Primary hyperparathyroidism and incidental multifocal metastatic papillary thyroid carcinoma in a man[J]. Arq Bras Endocrinol Metabol,2010, 54(6):578-582.
[2] Kosem M, Algun E, Kotan C, et al. Coexistent thyroid pathologies and high rate of papillary cancer in patients with primary hyperparathyroidism:controversies about minimal invasive parathyroid surgery[J]. Acta Chir Belg,2004, 104(5):568-571.
[3] Marcocci C, Saponaro F. Epidemiology, pathogenesis of primary hyperparathyroidism:Current data[J]. Ann Endocrinol (Paris),2015, 76(2):113-115.
[4] Adler J T, Chen H, Schaefer S, et al. Does routine use of ultrasound result in additional thyroid procedures in patients with primary hyperparathyroidism?[J].J Am Coll Surg,2010, 211(4):536-539.
[5] Khan A A, Hanley D A, Rizzoli R, et al. Primary hyperparathyroidism:review and recommendations on evaluation, diagnosis, and management. A Canadian and international consensus[J]. Osteoporos Int,2017, 28(1):1-19.
[6] Gates J D, Benavides L C, Shriver C D, et al. Preoperative thyroid ultrasound in all patients undergoing parathyroidectomy?[J]. J Surg Res,2009, 155(2):254-260.
[7] Arciero C A, Shiue Z S, Gates J D, et al. Preoperative thyroid ultrasound is indicated in patients undergoing parathyroidectomy for primary hyperparathyroidism[J]. J Cancer,2012, 3:1-6.
[8] Cuhaci N, Ozdemir D, Polat B, et al. Concomitant thyroid lesions in patients with primary hyperparathyroidism[J]. Asian J Surg, 2016. Jan 10, pii:S1015-9584(15)00143-8. doi:10.1016/j.asjsur.2015.10.006.
[9] Bentrem D J, Angelos P, Talamonti MS, et al. Is preoperative investigation of the thyroid justified in patients undergoing parathyroidectomy for hyperparathyroidism?[J].Thyroid,2002, 12(12):1109-1112.
[10] Lee K A, Jin H Y, Baek H S, et al. Importance of careful Tc-MIBI interpretation in patients with thyroid cancer and primary hyperparathyroidism[J]. Korean J Intern Med, 2015, 30(4):556-557.
[11] Yin X, Hu L, Wang X. Effects of thyroid cystectomy for primary hyperparathyroidism on immune function[J]. Pak J Med Sci,2016, 32(1):215-220.
[12] Spanheimer P M, Weigel R J. Management of patients with primary hyperparathyroidism and concurrent thyroid disease:an evolving field[J]. Ann Surg Oncol,2012, 19(5):1428-1429.
[13] Lindeman B M, Pesce C E, Tsai H L, et al. Lower vitamin D levels in surgical hyperparathyroidism versus thyroid patients[J]. Am Surg,2014, 80(5):505-510.
[14] Moley J F, Skinner M, Gillanders W E, et al. Management of the parathyroid glands during preventive thyroidectomy in patients with multiple endocrine neoplasia type 2[J]. Ann Surg, 2015, 262(4):641-646.
[15] 于军霞, 欧阳兆强,张霞,等.甲状旁腺腺瘤并原发性甲状旁腺功能亢进症临床特点及误诊原因分析[J].临床误诊误治,2015,28(11):21-25.
[16] 郭静霞, 任巧华,王欣,等.原发性甲状旁腺功能亢进症37例诊治分析[J].临床误诊误治,2014,27(4):32-34.
[17] Colombo C, Verga U, Mian C, et al. Comparison of calcium and pentagastrin tests for the diagnosis and follow-up of medullary thyroid cancer[J]. J Clin Endocrinol Metab, 2012, 97(3):905-913.
[18] Maia A L, Siqueira D R, Kulcsar M A, et al. Diagnosis, treatment, and follow-up of medullary thyroid carcinoma:recommendations by the Thyroid Department of the Brazilian Society of Endocrinology and Metabolism[J]. Arq Bras Endocrinol Metabol,2014, 58(7):667-700.
[19] Livolsi V A, Feind C R. Incidental medullary thyroid carcinoma in sporadic hyperparathyroidism. An expansion of the concept of C-cell hyperplasia[J]. Am J Clin Pathol,1979, 71(5):595-599.
[20] Machens A, Dralle H. Multiple endocrine neoplasia type 2:achievements and current challenges[J]. Clinics (Sao Paulo),2012, 67 Suppl 1:113-118.

原发性甲状旁腺功能亢进症与甲状腺疾病的关系探讨

Analysis of relationship between primary hyperparathyroidism and thyroid diseases

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