原发性醛固酮增多症伴PTH水平升高患者的临床特点
摘要
目的探讨原发性醛固酮增多症(PA)合并甲状旁腺激素(PTH)水平升高患者的临床特点。方法选择PA患者88例,收集其一般资料,入院后治疗前检测血尿生化指标及激素水平,根据PTH水平将患者分为PTH水平升高(血清PTH> 80. 00 pg/m L)组21例,PTH水平正常组(血清PTH 6. 00～80. 00 pg/m L) 67例。对比两组各指标的差异。结果 PTH水平升高组年龄较PTH水平正常组低(P <0. 05),两组性别、病程、体质量指数、血压、疾病类型比较差异无统计学意义(P均> 0. 05)。PTH水平升高组24 h尿钾、24 h尿钙及低血钙比例较PTH水平正常组高(P均<0. 05),两组血钾、血钙、血镁、低血钾比例、糖化血红蛋白、血肌酐、血尿酸比较差异无统计学意义(P均> 0. 05)。PTH水平升高组血卧位醛固酮水平较PTH水平正常组高(P <0. 05),两组其他激素指标比较差异无统计学意义(P均> 0. 05)。结论 PTH水平升高的PA患者较PTH水平正常PA患者发病年龄小,且更易发生低血钙,卧位醛固酮水平高。
引文
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[2]van Ballegooijen AJ,Reinders I,Visser M,et al.Serum parathyroid hormone in relation to all-cause and cardiovascular mortality:the Hoorn study.[J].J Clin Endocrinol Metab,2013,98(4):E638-E645.
[3]Tomaschitz A,Ritz E,Pieske B,et al.Aldosterone and parathyroid hormone interactions as mediators of metabolic and cardiovascular disease[J].Metabolism,2014,63(1):20-31.
[4]Salcuni AS,Palmieri S,Carnevale V,et al.Bone involvement in aldosteronism[J].J Bone Miner Res,2012,27:2217-2222.
[5]胡伟,唐荣华.以低钙抽搐为主要表现的原发性醛固酮增多症1例分析[J].中国误诊学杂志,2008,8(24):6038-6039.
[6]Mateus-Hamdan L,Beauchet O,Bouvard B,et al.High parathyroid hormone,but not low vitamin D concentrations,expose elderly inpatients to hypertension[J].Geriatr Gerontol Int,2013,13(3):783-791.
[7]van Ballegooijen AJ,Visser M,Kestenbaum B,et al.Relation of vitamin D and parathyroid hormone to cardiac biomarkers and to left ventricular mass(from the Cardiovascular Health Study)[J].Am J Cardiol,2013,111(3):418-424.
[8]Deo R,Katz R,Shlipak MG,et al.Vitamin D,parathyroid hormone,and sudden cardiac death:results from the Cardiovascular Health Study[J].Hypertension,2011,58(6):1021-1028.
[9]Maniero C,Fassina A,Seccia TM,et al.Mild hyperparathyroidism:a novel surgically correctable feature of primary aldosteronism[J].Hypertension,2012,30(2):390-395.
[10]Jiang Y,Zhang C,Ye L,et al.Factors affecting parathyroid hormone levels in different types of primary aldosteronism[J].Clin Endocrinol,2016,85(2):267-274.
[11]Decarlo KE,Agrawal N.Double hit!A unique case of resistant hypertension[J].BMJ Case Rep,2017,2017:bcr-2017-221530.
[12]Brunaud L,Germain A,Zarnegar R,et al.Serum aldosterone is correlated positively to parathyroid hormone(PTH)levels in patients with primary hyperparathyroidism[J].Surgery,2009,146(6):1035-1041.