Intraoperative Parathyroid Hormone Kinetics are Variable: An In-Vivo Analysis.

IF 1.3 4区医学 Q3 OTORHINOLARYNGOLOGY

Annals of Otology Rhinology and Laryngology Pub Date : 2025-02-01 Epub Date: 2024-11-09 DOI:10.1177/00034894241298155

Antoinette R Esce, Robert G Nicholas, Noah P Syme, Garth T Olson, Nathan H Boyd

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引用次数: 0

Abstract

Objectives: Intraoperative parathyroid hormone (IOPTH) monitoring has become routine in parathyroid surgery to facilitate less invasive techniques to treat hyperparathyroidism. Despite this, little is known about in vivo IOPTH kinetics, which can greatly affect the reliability of its interpretation.

Methods: A prospective cohort of patients undergoing routine parathyroidectomy was studied. During each case, IOPTH was measured frequently, during all key perioperative events. Qualitative, univariate, and multivariate analysis was performed to better understand the patterns of in vivo IOPTH kinetics.

Results: The IOPTH increased from preoperative baseline in every case, but some patients had a rapid spike after gland manipulation while others had a more gradual increase. The IOPTH peak occurred prior to excision in almost every case. The IOPTH began to fall prior to excision, typically returning to preoperative baseline levels just before excision. The average in vivo half-life of parathyroid hormone (PTH) was 5.2 minutes.

Conclusion: There is substantial variation in the in vivo IOPTH kinetics and more research is needed to understand predictors of kinetic patterns and PTH half-life during parathyroidectomy.

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术中甲状旁腺激素动力学是可变的：体内分析

目的：术中甲状旁腺激素（IOPTH）监测已成为甲状旁腺手术的常规方法，有助于采用微创技术治疗甲状旁腺功能亢进症。尽管如此，人们对体内 IOPTH 动力学知之甚少，这可能会极大地影响其解释的可靠性：方法：对接受常规甲状旁腺切除术的患者进行了前瞻性队列研究。方法：对接受常规甲状旁腺切除术的前瞻性队列患者进行了研究，在每个病例的所有关键围术期事件中都频繁测量了 IOPTH。为了更好地了解体内 IOPTH 动力学的模式，我们进行了定性、单变量和多变量分析：结果：每个病例的 IOPTH 都从术前基线开始上升，但有些患者在腺体操作后迅速飙升，而有些患者则是逐渐上升。几乎每个病例的 IOPTH 峰值都出现在切除术之前。IOPTH 在切除术前开始下降，通常在切除术前恢复到术前基线水平。甲状旁腺激素（PTH）在体内的平均半衰期为 5.2 分钟：体内 IOPTH 动力学存在很大差异，需要进行更多的研究来了解甲状旁腺切除术期间的动力学模式和 PTH 半衰期的预测因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Otology Rhinology and Laryngology 医学-耳鼻喉科学

CiteScore

3.10

自引率

7.10%

发文量

171

审稿时长

4-8 weeks

期刊介绍： The Annals of Otology, Rhinology & Laryngology publishes original manuscripts of clinical and research importance in otolaryngology–head and neck medicine and surgery, otology, neurotology, bronchoesophagology, laryngology, rhinology, head and neck oncology and surgery, plastic and reconstructive surgery, pediatric otolaryngology, audiology, and speech pathology. In-depth studies (supplements), papers of historical interest, and reviews of computer software and applications in otolaryngology are also published, as well as imaging, pathology, and clinicopathology studies, book reviews, and letters to the editor. AOR is the official journal of the American Broncho-Esophagological Association.