[Coagulation function analysis and postoperative changes in patients with primary hyperparathyroidism]

Objective:To investigate the preoperative coagulation characteristics and postoperative changes in patients with primary hyperparathyroidism（PHPT）. Methods:A retrospective analysis was conducted on the clinical data of 55 PHPT patients treated at Beijing Chaoyang Hospital, including preoperative and postoperatively（1 week） serum calcium, serum phosphorus, parathyroid hormone（PTH）, 25-hydroxyvitamin D, prothrombin time（PT）, activated partial thromboplastin time（APTT）, fibrinogen（FIB）, thrombin time（TT）, D-dimer（D-Dimer）, and thromboelastography（TEG） parameters such as coagulation index（CI）, reaction time（R）, kinetic time（K）, maximum amplitude（MA）, and lysis at 30 minutes（LY30）. The preoperative coagulation status and the impact of postoperative biochemical changes on coagulation function were analyzed. Results:All 55 patients successfully underwent parathyroid tumor resection, pathological findings were 41 cases of adenoma（74.5%）, 12 cases of atypical tumor（21.8%）, and 2 cases of carcinoma（3.6%）. The median preoperative serum calcium and PTH levels were 2.67 mmol/L and 171.60 pg/mL, respectively. All patients had PT, APTT, FIB, TT, CI, MA, K, and LY30 values within normal ranges, but 11 patients（20.0%） exhibited reduced preoperative R values. Compared to the normal R-value group, the reduced R-value group had shorter APTT, higher D-Dimer, and higher CI values, with statistically significant differences（P<0.05）, suggesting a hypercoagulable state preoperatively. One week postoperatively, the median serum calcium and PTH levels significantly decreased to 2.14 mmol/L and 35.10 pg/mL, respectively（P<0.05）. Except for a slight increase in D-Dimer, PT, APTT, FIB, TT, CI, MA, K, and LY30 values remained stable within normal ranges. The differences in APTT, D-Dimer, and CI values between the reduced R-value group and the normal R-value group were no longer statistically significant（P>0.05）. Conclusion:Some PHPT patients exhibit a hypercoagulable state with reduced R values preoperatively, and surgical resection of parathyroid tumor helps improve coagulation function in these patients.