摘要
末期肾病患者约有30％～50％会发生甲状旁腺功能亢进。肾性甲状旁腺功能亢进引起多个系统疾病，影响患者生活质量，严重者危及生命。目前治疗有2种方法，即西那卡塞为主的内科治疗和经典外科手术切除，本文就2者特点结合最新研究进行分析。本研究认为西那卡塞适用于：①轻到中度继发性甲状旁腺功能患者；②对外科手术不能接受的患者；③手术禁忌证患者，比如重度骨骼畸形不能平躺，心肺功能不能耐受麻醉，肝脏及凝血功能严重障碍等。外科手术适用于：①肾移植术后三发性甲状旁腺功能亢进患者；②西那卡塞无效患者；③不能耐受西那卡塞副作用患者；④无法承担西塞卡塞治疗经济负担患者。但这些结论仍需更高级别临床试验进行验证。
Patients with end-stage renal disease have a 30%-50% incidence of hyperparathyroidism. Re- nal hyperparathyroidism causes multiple systemic diseases, which affect the life quality of patients, and seriously endangers patients＇ life. Now there are two major treatments, Ciuacalcet and surgery. This article is aimed to discuss the characteristics of the two methods and review the latest research on renal hyperparathyroidism. It is ad- vised that Cinacalcet may apply to： 1, patients with mild to moderate secondary hyperparathyroidism; 2, patients who do not accept the surgery; 3, patients with surgical contraindication. And surgical procedures are applicable to： 1, patients with tertiary hyperparathyroidism after kidney transplantation; 2, patients with invalid Cinacalcet treatment; 3, patients who cannot tolerate the side-effect of Cinacalcet; 4, patients unable to undertake economic burden of Cinacalcet. However, these conclusions still require higher levels of clinical trials to be validated.
作者
于芳
贺青卿
Yu Fang;He Qingqing(Department of Thyroid and Breast Surgery, the General Hospital of Jinan Military Command of PLA, Jinan 250031, China)
出处
《中华内分泌外科杂志》
CAS
2018年第2期92-95,共4页
Chinese Journal of Endocrine Surgery
基金
中国博士后科学基金第三批特别资助项目（201003759）
济南军区总医院院长基金资助项目（2016ZD02）
