在一次性甲状腺功能障碍症中甲状腺激素升高的程度:一天的时间是否重要?
C Corbin Frye1, Janessa Sullivan2, Sai Anusha Sanka2
1Department of Surgery, Section of Surgical Oncology, Washington University School of Medicine, Saint Louis, MO; Department of Surgery, Section of Minimally Invasive Surgery, Washington University School of Medicine, Saint Louis, MO.
甲状腺上腺激素 (PTH) 水平在原发性甲状腺功能障碍患者的早晨较低. 这种白天PTH的变化可能会影响外科手术的决策,特别是对于那些患有单腺疾病的人.
科学领域:
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
- 临床化学 临床化学
背景情况:
- 副甲状腺激素 (PTH) 在健康个体中表现出昼夜节律.
- 目前尚不清楚这种白天变化是否会在原发性副甲状腺功能障碍症中持续存在.
- 事观察表明在甲状腺外科手术前,早晨PTH水平较低.
研究的目的:
- 在患有原发性副甲状腺功能障碍症的患者中调查副甲状腺激素的日间变化.
- 确定日间PTH测量的临床影响在手术内决策.
主要方法:
- 对418名因原发性甲状腺功能障碍而接受副甲状腺切除术的患者的回顾性图表审查 (2019年10月 - 2022年2月).
- 分析了933个副甲状腺激素水平,使用混合模型进行重复测量.
- 在早上6点到下午12点之间绘制的PTH值的比较.
主要成果:
- 甲状腺激素水平在上午7点之前抽取时显著降低.
- 这种白天变化在单腺和高级甲状腺功能障碍症患者中观察到.
- 在多腺体或低基线PTH疾病中,这种变异并不显著.
结论:
- 初级甲状腺功能障碍症患者在清晨表现出明显较低的PTH水平.
- 这种早晨的白天变化在单腺和高基线PTH疾病中尤其明显.
- 早晨的切口前PTH测量可能会影响手术内外科手术决策.
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