Percutaneous thermal ablation of the parathyroid glands is associated with short-term echocardiographic improvements in left ventricular structure and function in patients with end-stage renal disease and secondary hyperparathyroidism.
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引用次数: 0
Abstract
Objective: To observe the effects of ultrasound-guided percutaneous thermal ablation of the parathyroid glands on the left ventricular structure and function in patients with end-stage renal disease (ESRD) and secondary hyperparathyroidism (SHPT).
Methods: Retrospective cohort study (May 2019-March 2025). Patients: thermal ablation (n = 64) vs. medical therapy (n = 115). Propensity score matching (1:1, caliper 0.2) based on gender, age, baseline PTH, serum calcium, left ventricular mass index (LVMI) yielded 108 patients (54/group). Multivariable regression adjusted for residual confounding. Measurements at baseline and 6 months. Changes in LVMI, LVEF, PTH, phosphorus, serum calcium, blood pressure compared.
Results: After matching, in the thermal ablation group, LVMI, PTH, serum phosphorus, serum calcium, and systolic blood pressure (SBP) at 6 months decreased compared with baseline (all p < 0.05). In the medical therapy group, serum calcium decreased compared with baseline (p < 0.05). Inter-group comparisons showed that the reductions in LVMI, PTH, serum phosphorus, serum calcium, and SBP were greater in the thermal ablation group than in the medical therapy group (all p < 0.05). Multivariable regression analysis showed that thermal ablation was independently associated with a greater percentage reduction in LVMI (95% CI: 7.49-24.44, p < 0.001). In the thermal ablation subgroup with baseline left ventricular systolic dysfunction, LVEF increased from baseline to 6 months (p = 0.017).
Conclusion: Ultrasound-guided percutaneous thermal ablation of the parathyroid glands was associated with greater reductions in PTH, serum phosphorus, serum calcium, SBP and LVMI than medical therapy. In the pilot subgroup of patients with baseline left ventricular systolic dysfunction, LVEF showed an increase after thermal ablation.
目的：观察超声引导下经皮甲状旁腺热消融对终末期肾病（ESRD）伴继发性甲状旁腺功能亢进（SHPT）患者左室结构和功能的影响。方法：回顾性队列研究（2019年5月- 2025年3月）。患者：热消融（n = 64） vs药物治疗（n = 115）。基于性别、年龄、基线PTH、血清钙、左心室质量指数（LVMI）的倾向评分匹配（1:1，卡尺0.2）得到108例患者（54例/组）。多变量回归校正了残留混杂。基线和6个月时的测量。LVMI、LVEF、PTH、磷、血钙、血压变化比较。结果：配对后，热消融组6个月LVMI、PTH、血清磷、血清钙、收缩压（SBP）均较基线降低（p p p p p = 0.017）。结论：超声引导下经皮甲状旁腺热消融与药物治疗相比，PTH、血清磷、血清钙、收缩压和LVMI的降低幅度更大。在基线左室收缩功能不全患者的先导亚组中，热消融后LVEF增加。
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