甲状旁腺素测定预测甲状腺全切除术后低钙血症的价值

摘要

目的 探讨甲状腺全切除术后血清1h完整甲状旁腺素(1 h-iPTH)的测定在早期预测低钙血症中的临床价值.方法 103例甲状腺全切除患者于术后1及24 h分别检测血清1 h-iPTH及24 h校正血钙(24 h-cCa).结果 103例甲状腺全切除患者术后低钙血症的发生率为37.9％(39/103),其中低钙血症患者1 h-iPTH水平显著低于血钙正常患者(P＜0.01).术后1 h-iPTH＜ 16 pg/mL患者低钙血症的发生率显著高于1 h-iPTH≥16 pg/mL患者(P＜0.01).以术后1 h-iPTH＜ 16 pg/mL作为术后低钙血症的预测指标,其敏感性、特异性和准确率分别为82.1％、90.6％和87.4％.结论 甲状腺全切除术后1 h-iPTH与术后低钙血症的发生存在较强的相关性,术后1 h-iPTH可以作为诊断低钙血症的指标.%Objective To investigate the early predictive significance of serum 1 h intact parathyroid hormone (1h-iPTH) determination in patients with hypocalcemia after total thyroidectomy.Methods A total of 103 patients undergoing total thyroidectomy were enrolled,and I h-iPTH and serum 24 h corrected calcium (24h-cCa) levels were determined after total thyroidectomy 1 h and 24 h.Results Among the 103 patients undergoing total thyroidectomy,the incidence of postoperative hypocalcemia was 37.9％ (39/103),and the 1h-iPTH level in patients with hypocalcemia was lower than that in patients with normocalcemia (P ＜0.01).The incidence of hypocalcemia in patients with 1h-iPTH ＜ 16 pg/mL was higher than that in patients with 1 h-iPTH ≥ 16 pg/mL(P ＜ 0.01).When 1h-iPTH ＜ 16 pg/mL was as a predictor for hypocalcemia,the sensitivity,specificity and accuracy were 82.1％,90.6％ and 87.4％,respectively.Conclusions 1 h-iPTH after total thyroidectomy shows a strong correlation with postoperative hypocalcemia,and could be as an indicator for diagnosing hypocalcemia.