摘要
目的探讨医院内高钙血症的流行病学情况。方法从首都医科大学宣武医院信息中心获取2011年全年住院患者信息,31018例住院患者中,18388例(59.3%)检测血钙;其中56例血钙值>2.67 mmol/L,进一步分析高钙血症原因,从中筛出可疑原发性甲状旁腺功能亢进症(primary hyperparathyroidism,PHPT)患者,对其进行随访,并复查血钙及血甲状旁腺素(parathyroid hormone,PTH),两次及以上高钙血症及高PTH(>65 ng/L)者确诊为PHPT。结果该院2011年住院患者高钙血症患病率为0.3%,56例高钙血症患者中,死亡6例(10.7%),拒绝复查及失访6例(10.7%),复查血钙和PTH结果正常9例(16.1%),实验室误差7例(12.5%),医源性高钙血症1例(1.8%),原因不明4例(7.1%),恶性肿瘤导致高钙血症13例(23.2%),PHPT 7例(12.5%),慢性肾衰竭3例(5.4%)。恶性肿瘤所致高钙血症中,肺癌所占比例最高[6例(46.1%)]。该院住院患者中PHPT的患病率为38.1/10万。结论该院住院患者高钙血症的最常见原因为恶性肿瘤,其次是PHPT。该院的住院患者高钙血症患病率与欧美的研究数据相近,而PHPT患病率却低于欧美报道,应重视PHPT的筛查。
Objective To investigate epidemiology of hypercalcemia in hospital.Methods The blood calcium value of hospitalized patients in Xuanwu Hospital in 2011 was screened,and the etiology of hypercalcemia was analyzed.Among 31018 hospitalized patients,18388 cases(59.3%)were tested for serum calcium,and there were 56 patients with blood calcium value greater than 2.67 mmol/L.Medical records were reviewed,etiology of high blood calcium were analyzed.The patients with suspicious primary hyperparathyroidism(PHPT)were screened out,followed up,and re-examined for blood calcium and parathyroid hormone(PTH).The patients with high blood calcium and high PTH(>65 ng/L)were diagnosed with PHPT.Results In the study,the prevalence of hypercalcemia was 0.3%.Among the 56 patients with high serum calcium,six patients(10.7%)died,six(10.7%)refused reexamination or lost follow-up,nine(16.1%)had normal reexam results of serum calcium and PTH,seven(12.5%)had test error,one(1.8%)had iatrogenic high serum calcium,13(23.2%)had malignant tumor,seven(12.5%)were diagnosed with PHPT,three(5.4%)had chronic renal failure,the cause was unknown in four cases(7.1%).Among the patients with hypercalcemia caused by malignant tumor,the proportion of lung cancer was the highest(46.1%).It concluded that the prevalence of PHPT in hospitalized patients was 38.1/100000.Conclusions The most common cause of hypercalcemia in hospitalized patients is malignant tumor,and the second is PHPT.The prevalence of hypercalcemia in hospitalized patients in this study is similar to that in the European and American studies,but the prevalence of PHPT is lower,which suggests that PHPT should be focused.
作者
李楠
罗斌
Li Nan;Luo Bin(Department of General Surgery,Daxing Teaching Hospital,Capital Medical University,Beijing 102600,China)
出处
《北京医学》
CAS
2020年第3期214-217,共4页
Beijing Medical Journal
