特发性甲状旁腺功能减退症25例临床分析

摘要

To study the clinical characteristics, diagnosis and therapy of idiopathic hypoparathyroidism. Methods The clinical data of 25 cases of idiopathic hypoparathyroidism in West China Hospital of Sichuan University were collected and analyzed retrospectively. Results The major symptoms in these cases were as follow: tetanys of the distal extremities (84％), seizures (32％), paresthesias of the distal extremities (44％), fatigue (44％), syncope (16％),extrapyramidal dysfunction (16％). Cerebral calcification were detected in 75％ of 20 patients who underwent head CT. The misdiagnosis rate is 44％. The misdiagnosed diseases include primary epilepsy, calcium dofioiency,myositis, rhcumatism. Conclusion In our series most patients were casily misdiagnosed. To avoid misdiagnosis, clinicians should be alert to the manifestations related to hypocalcemia. The long-term treatment of hypocalcemia in patients with idiopathic hypoparathyroidism involves the administration of oral calcium and vitamin D or analogues.%目的 探讨特发性甲状旁腺功能减退症(IHP)的临床特点、诊断及治疗.方法 对华西医院内分泌科收治的IHP病例25例进行回顾性分析.结果 本组IHP患者的常见症状为:手足抽搐发生率为84%,癫痫发生率为32%,肢端麻木发生率为44%,乏力发生率为44%,晕厥发生率为16%,锥体外系症状为16%.20例行头颅CT检查,75%(15例)发现颅内钙化.误诊率为44%.主要误诊为:原发性癫痫、缺钙、肌炎、风湿.结论 本病临床表现复杂,易被误诊.为减少误诊,临床医生应警惕低钙血症的临床表现.长期治疗包括钙剂和维生索D或其衍生物.