血钙正常的原发性甲状旁腺功能亢进症

摘要

Normocalcemic primary hyperparathyroidism is a disease being recognized recently .It is diagnosed by consistently normal levels of serum total calcium and ionized calcium combined with elevated parathyroid hormone ( PTH) levels , excluding of secondary causes of hyperparathyroidism .It is found mostly in patients referred for osteoporosis , kid-ney stones or other diseases .Some patients are asymptomatic , but some have osteoporosis , fractures, kidney stones and other target organ damage or metabolic abnormalities .There is no consensus about its pathogenesis , clinical manifesta-tion, natural process and outcomes .It is reported that bisphosphonates , cinacalcet or surgical resection may be effective .%血钙正常的原发性甲状旁腺功能亢进症是近年来逐渐被认识的疾病，其诊断要点是血总钙、血离子钙水平持续正常，血甲状旁腺素（ parathyroid hormone ， PTH）水平升高，同时需除外继发性甲状旁腺功能亢进的因素。其诊断多在进行骨质疏松症或其他疾病检查时发现，部分患者临床无症状，部分有骨质疏松、骨折、肾结石等靶器官损害或代谢异常。关于其发病机制、临床表现、自然进程、转归目前尚无统一意见，双膦酸盐、拟钙剂药物治疗及手术切除治疗或有益处。