离子钙和甲状旁腺素作为甲状腺全切除术后甲状旁腺功能减退的预测因子。

IF 1.9 3区医学 Q2 OTORHINOLARYNGOLOGY

European Archives of Oto-Rhino-Laryngology Pub Date : 2025-06-01 Epub Date: 2025-01-24 DOI:10.1007/s00405-025-09205-2

Mario Sánchez-Canteli, María Pasarón-Canga, María Riestra-Fermández, Gala Gutiérrez-Buey, Patricia Martínez-González, Raquel Fernández-Morais, Marta Elena Fernández-Pello, Juan Carlos Álvarez-Méndez

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引用次数: 0

摘要

目的：甲状旁腺功能低下（POSH）是甲状腺全切除术后常见的并发症。本研究旨在评估术后第一天（POD-1）血清、离子钙和甲状旁腺素水平的准确性，以预测术后低钙血症（PoHC）、一过性甲状旁腺功能低下（THPT）和永久性甲状旁腺功能低下（PtHPT）。方法：回顾性分析200例患者的生化指标及临床指标。采用ROC曲线分析确定最佳分界点。结果与分析和临床变量以及患者预后相关。结果：POD-1中PoHC的发生率为46%；THPT和PtHPT分别为37%和9%。结论：POD-1上的离子钙能准确预测PoHC，而血清PTH提示PtHPT风险较高。

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Ionized calcium and PTH as predictors of hypoparathyroidism following total thyroidectomy.

Purpose: Post-surgical hypoparathyroidism (POSH) is a common complication after total thyroidectomy. This study aims to assess the accuracy of serum and ionized calcium and PTH levels on the first postoperative day (POD-1) to predict postoperative hypocalcemia (PoHC), transient hypoparathyroidism (THPT), and permanent hypoparathyroidism (PtHPT).

Methods: Biochemical parameters and clinical variables were retrospectively analyzed in 200 patients. The optimal cut-off points were determined using ROC curve analysis. Results were correlated with analytical and clinical variables and patient outcomes.

Results: PoHC incidence in POD-1 was 46%; THPT and PtHPT were 37 and 9%, respectively. Ionized calcium < 4.43 mg/dL on POD-1 predicted PoHC (AUC = 0.9) better than PTH and serum calcium. PTH < 8.06 pg/mL on POD-1 predicted PtHPT (AUC = 0.797). Multivariate analysis identified PTH < 21.2 pg/mL, ionized calcium < 4.43 mg/dL, and serum calcium < 8.76 mg/dL on POD-1 as significant PoHC risk factors.

Conclusion: Ionized calcium on POD-1 predicts PoHC accurately, while serum PTH indicates higher risk for PtHPT.

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来源期刊

European Archives of Oto-Rhino-Laryngology 医学-耳鼻喉科学

CiteScore

5.30

自引率

7.70%

发文量

537

审稿时长

2-4 weeks

期刊介绍： Official Journal of European Union of Medical Specialists – ORL Section and Board Official Journal of Confederation of European Oto-Rhino-Laryngology Head and Neck Surgery "European Archives of Oto-Rhino-Laryngology" publishes original clinical reports and clinically relevant experimental studies, as well as short communications presenting new results of special interest. With peer review by a respected international editorial board and prompt English-language publication, the journal provides rapid dissemination of information by authors from around the world. This particular feature makes it the journal of choice for readers who want to be informed about the continuing state of the art concerning basic sciences and the diagnosis and management of diseases of the head and neck on an international level. European Archives of Oto-Rhino-Laryngology was founded in 1864 as "Archiv für Ohrenheilkunde" by A. von Tröltsch, A. Politzer and H. Schwartze.