目的 探讨术前维生素D测定在早期预测全甲状腺切除术后低钙血症中的临床价值.方法 术前检测220例接受全甲状腺切除术患者血清维生素D水平,分析其与术后低钙血症发生的关系.结果 220例全甲状腺切除术患者术后低钙血症发生率为58.18%,其中维生素D缺乏者(<20ng/ml)低钙血症的发生率为62.5%,高于维生素D正常者(>20ng/ml)46.7%.维生素D缺乏者的术前平均PTH值为(17.40±4.6)pg/ml,维生素D正常水平者的术前PTH值为(16.18±3.6)pg/ml.维生素D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62.5%、53.3%及60.0%.结论 全甲状腺切除术后维生素D与术后低钙血症的发生存在较强的相关性,术前维生素D测定可以作为预测全甲状腺术后低钙血症的指标.%Objective To investigate the early predictive significance of Vitamin D determination in patients with hypocalcemia after total thyroidectomy. Methods A total of 220 patients who underwent total thyroidectomy were enrolled,and Vitamin D levels were determined preoperation. Results Among the 220 patients underwent total thyroidectomy,the incidence of postoperative hypocalcemia was 58.18%,and the incidence of hypocalcemia was 62.5% in Vitamin D deficient patients,higher than the patients with vitamin D sufficient. The preoperative parathyroid hormone was 17.40±4.6 pg/ml in Vitamin D deficient patients,and 16.18±3.6 pg/ml in vitamin D sufficient patients. Vitamin D was a predictor for hypocalcemia, the sensitivity,specificity and accuracy were 62.5%、53.3% and 60.0%,respectively. Conclusions Vitamin D preoperation shows a strong correlation with postoperative hypocalcemia,and can be used as an indicator for diagnosing hypocalcemia.
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