甲状旁腺手术后的饥饿骨综合征

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Ya-Ling Tai, Hsin-Yi Shen, Wei-Hsuan Nai, Jen-Fen Fu, I-Kuan Wang, Chien-Chang Huang, Cheng-Hao Weng, Cheng-Chia Lee, Wen-Hung Huang, Huang-Yu Yang, Ching-Wei Hsu, Tzung-Hai Yen
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引用次数: 2

摘要

关于透析患者甲状旁腺切除术后饥饿骨综合征的发生率数据不一致,公布的发生率从15.8%到92.9%不等。方法2009年至2019年,120例血液透析患者在长庚纪念医院因继发性甲状旁腺功能亢进接受甲状旁腺切除术。根据甲状旁腺切除术后出现饥饿骨综合征(n = 100)或未出现饥饿骨综合征(n = 20)将患者分为两组。结果甲状旁腺次全切除术是最常见的手术(76.7%),其次是甲状旁腺全切除术并自体植入术(23.3%)。病理检查显示甲状旁腺增生。饥饿骨综合征发生时间为0.3±0.3个月,持续时间为11.1±14.7个月。术后,与无饥饿骨综合征患者相比,饥饿骨综合征患者的最低点矫正钙水平(P < 0.001)较低,完整甲状旁腺激素水平(P < 0.001)较低。随访59.3±44.0个月,持续和复发甲状旁腺功能亢进患者分别为25例(20.8%)和30例(25.0%)。此外,有饥饿骨综合征的患者发生持续性甲状旁腺功能亢进的比例低于无饥饿骨综合征的患者(P < 0.001)。4例(3.3%)患者接受了第二次甲状旁腺切除术。饥饿骨综合征患者接受第二次甲状旁腺切除术的次数少于无饥饿骨综合征患者(P < 0.001)。最后,多因素logistic回归模型显示术前血铁蛋白水平是饥饿骨综合征发展的负向预测因子(P = 0.038)。血液透析患者继发性甲状旁腺功能亢进行甲状旁腺切除术后,饥饿骨综合征很常见(83.3%),该并发症应予以监测和适当处理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Hungry bone syndrome after parathyroid surgery

Introduction

Data on the incidence rates of hungry bone syndrome after parathyroidectomy in patients on dialysis are inconsistent, as the published rates vary from 15.8% to 92.9%.

Methods

Between 2009 and 2019, 120 hemodialysis patients underwent parathyroidectomy for secondary hyperparathyroidism at the Chang Gung Memorial Hospital. The patients were stratified into two groups based on the presence (n = 100) or absence (n = 20) of hungry bone syndrome after parathyroidectomy.

Findings

Subtotal parathyroidectomy was the most common surgery performed (76.7%), followed by total parathyroidectomy with autoimplantation (23.3%). Pathological examination revealed parathyroid hyperplasia. Hungry bone syndrome developed within 0.3 ± 0.3 months and lasted for 11.1 ± 14.7 months. After surgery, compared with patients without hungry bone syndrome, patients with hungry bone syndrome had lower levels of nadir corrected calcium (P < 0.001), as well as lower nadir (P < 0.001) and peak (P < 0.001) intact parathyroid hormone levels. During 59.3 ± 44.0 months of follow-up, persistence and recurrence of hyperparathyroidism occurred in 25 (20.8%) and 30 (25.0%) patients, respectively. Furthermore, patients with hungry bone syndrome had a lower rate of persistent hyperparathyroidism than those without hungry bone syndrome (P < 0.001). Four patients (3.3%) underwent a second parathyroidectomy. Patients with hungry bone syndrome received fewer second parathyroidectomies than those without hungry bone syndrome (P < 0.001). Finally, a multivariate logistic regression model revealed that the preoperative blood ferritin level was a negative predictor of the development of hungry bone syndrome (P = 0.038).

Discussion

Hungry bone syndrome is common (83.3%) after parathyroidectomy for secondary hyperparathyroidism in patients undergoing hemodialysis, and this complication should be monitored and managed appropriately.

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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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