帕米磷酸二钠在治疗原发性甲状旁腺功能亢进合并高钙危象中的作用.docVIP

帕米磷酸二钠在治疗原发性甲状旁腺功能亢进合并高钙危象中的作用 　　【摘要】目的 观察帕米磷酸二钠在治疗原发性甲状旁腺功能亢进症（PHPT）所导致的高钙危象中的降血钙作用。方法 因甲旁亢导致高钙危象共9人次、12例次，其中甲状旁腺癌4例、甲状旁腺腺瘤3例、甲状旁腺增生2例。12例次高钙危象治疗中均应用帕米磷酸二钠。对用药治疗前后的实验室数据进行统计分析。结果 （1）治疗前最高血钙水平3.75（3.66、3.99）mmol/L，治疗第2 d血钙水平3.44（2.95、3.78）mmol/L，第3 d血钙水平2.79（2.50、3.14）mmol/L，最低水平2.25（2.00、2.55）mmol/L，各阶段血钙水平差异具有统计学意义（P0.05）。（2）药物治疗后血总钙水平降至3.5 mmol/L以下所用时间为2～3 d，（2.27±0.65）d。血总钙保持于3.5 mmol/L以下时间为4～40 d，（8.45±12.30）d。结论 帕米磷酸二纳在甲旁亢所引起的高钙危象治疗中可快速发挥降低血钙的作用，多可以在应用药物24 h左右明显降低血钙水平，并在治疗第2至第3天将血钙水平降至安全范围（3.5 mmol/L）。 　　【关键词】甲状旁腺功能亢进症；高钙危象；帕米磷酸二钠 　　The efficacy of disodium Pamidronate in the treatment of primary hyperparathyroidism complicated by hypercalcemic crisis 　　Wang Chen，Shuai Xuejun，Zhu Yuqing， The Second Area of International Medical Department， China-Japan Friendship Hospital，Beijing 10029，China 　　Corresponding author： Zhu Yuqing，Email： trwangchen@126.com 　　【Abstract】Objective To study the efficacy of disodium pamidronate in the treatment of patients with primary hyperparathyroidism（PHPT） complicated by hypercalcemic crisis. Methods A total of 9 patients （12 cases）admitted into our hospital were diagnosed as PHPT complicated by hypercalcemic crisis. Of them，4 patients had parathyroid carcinoma，3 patients had parathyroid adenoma，2 patients had parathyroid hyperplasia. The intravenous disodium pamidronate was given for 12 times in all 9 patients. Serum calcium were monitored before and after treatment. Results Before the treatment， the serum calcium levels was 3.75（3.66，3.99）mmol/L.On the second and third day after the treatment with disodium pamidronate ， the serum calcium levels were 3.44（2.95，3.78）mmol/L and 2.79（2.50，3.14）mmol/L.The lowest level of serum calcium after treatment was 2.25（2.00，2.55）mmol/L.There were significant differences in the level of serum calcium of different days（P0.05）. On the second and third day， the change of serum calcium were 0.46（0.10，0.88）mmol/L，0.60（0.25，0.75）mmol/L ，there were no differences. After intravenous disodium pa