在全甲状腺切除术后的术后偏激素水平和永久性偏甲状腺功能障碍症:为临床医生提供线索
Annali italiani di chirurgia
|August 2, 2023
概括
在整体甲状腺切除术 (TT) 后的术后第一天,完整的副甲状腺激素 (iPTH) 水平超过1ppg/ml,表明永久性甲状腺缺血症 (PHPP) 的风险较低. 这种早期的iPTH测量可以帮助预测哪些患者不会因为缺甲状腺症而发展长期并发症.
科学领域:
- 内分泌学 在内分泌学.
- 手术并发症 手术并发症
- 在瘤学瘤学.
背景情况:
- 甲状腺功能低下症 (HPP) 是全甲状腺切除术 (TT) 的常见并发症.
- 预测永久性缺甲状腺症 (PHPP) 早期对患者管理至关重要.
- 在甲状腺切除术后,监测和副甲状腺激素水平至关重要.
研究的目的:
- 评估TT后PHPP手术后第1天完整副激素 (iPTH) 水平的预测值.
- 为PHPP风险评估确定可靠的早期生物标志物.
主要方法:
- 研究了一组407名接受TT治疗的患者.
- 完整的副激素 (iPTH),和白蛋白在术后第一天被测量.
- 患者根据术后第一天的IPTH水平 (高于或低于12ppg/ml) 进行分类,并对PHPP进行6个月的跟踪.
主要成果:
- 两组之间没有发现显著的人口或组织病理学差异.
- 2名患者出现了永久性副甲状腺功能低下症 (PHPP),而98名患者经历过渡性HPP.
- 术后第一天IPTH水平>1ppg/ml的患者没有发展PHPP.
结论:
- 手术后的第一天,超过1 pg/ml的IPTH水平是预防PHPP发展的强有力的指标.
- 这种简单的生化标志物可以帮助在全甲状腺切除术后对低甲状腺腺功能障碍的早期风险分层.
相关概念视频
The Parathyroid Glands
2.2K
The two pairs of parathyroid glands embedded within the posterior surface of the thyroid gland are restricted by a dense capsule around them. These glands comprise two distinct cell populations—parathyroid oxyphil and parathyroid principal cells- pivotal in calcium homeostasis.
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by...
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by...
2.2K
Hormones and Bone Tissue
2.7K
The endocrine system produces and secretes hormones, which interact with the skeletal system. These hormones control bone growth, maintain bone once it is formed, and remodel it.
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
2.7K
Skeleton and Calcium Homeostasis
4.6K
Calcium is not only the most abundant mineral in bone but also the most abundant mineral in the human body. Calcium ions are needed for bone mineralization, tooth health, heart rate regulation and strength of contraction, blood coagulation, the contraction of smooth and skeletal muscle cells, and the regulation of nerve impulse conduction. The average calcium level in the blood is about 10 mg/dL. When the body cannot maintain this level, a person will experience hypo or hypercalcemia.
4.6K
Synthesis and Regulation of Thyroid Hormones
4.7K
Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
4.7K
Synthesis and Functions of Calcitonin
2.0K
Calcitonin, a vital polypeptide hormone, regulates calcium levels within body fluids. It is released by the parafollicular cells, also known as C cells, situated in the follicular epithelium of the thyroid gland. Calcitonin responds to fluctuations in blood calcium levels and the influence of gastrointestinal hormones like gastrin and cholecystokinin.
The exact mechanisms by which calcitonin operates in calcium homeostasis remain elusive, but its significance is evident in several vital...
The exact mechanisms by which calcitonin operates in calcium homeostasis remain elusive, but its significance is evident in several vital...
2.0K
Functions of Thyroid Hormones
2.8K
The thyroid hormone (TH) plays a pivotal role in the intricate orchestration of physiological processes, exerting profound effects on development, metabolism, and homeostasis throughout different life stages.
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
2.8K


