肾结石合并原发性甲状旁腺功能亢进的诊治体会

摘要

Objective To investigate the diagnosis and management of primary hyperparathyroidism with repeated bilateral renal stones. Methods Clinical data of 5 patients diagnosed with primary hyperparathyroidism with repeated bilateral renal stones during Feb. 2009 to March 2011 were analyzed retrospectively. Results The 5 patients included 2 men and 3 women, pathologically diagnosed as with parathyroid adenoma, mean age (35. 6 + 9. 6) years(18-56), stone history (2. 4 + 0.3) years(0. 5-3. 0). Their serum calcium and PTH level elevated obviously, while serum phosphate reduced. After resection of the parathyroid adenoma, the patients' serum calcium, phosphate and PTH returned to normal. Conclusions Parathyroid-ectomy is effective to treat the disease, which can reduce recurrence of kidney stones remarkably. Early diagnosis and treatment of primary hyperparathyroidism is helpful to reduce stone recurrence and preserve renal function. Patients should be followed up closely in case they need appropriate treatment.%目的 探讨反复双肾结石患者中原发性甲状旁腺机能亢进的诊断和治疗,提高对本病的认识.方法 回顾性分析2009年2月~2011年3月因反复双肾结石就诊,临床诊断原发甲旁亢5例的资料.结果 5例病理证实为甲状旁腺腺瘤,男2例,女3例,年龄18~56岁,平均年龄(35.6±9.6)岁,结石病史0.5~3.0年,平均时间(2.4±0.3)年.血钙和甲状旁腺激素明显升高,血磷降低.切除腺瘤后,患者血钙、血磷和甲状旁腺激素恢复正常.结论 手术是治疗原发甲旁亢的有效方法.甲状旁腺手术可以明显降低结石复发,甲旁亢的早期诊治有益于减少结石复发和保护肾功能.术后应密切随访尿路结石,必要时予相应治疗.