维生素D缺乏是否真的会增加手术后缺甲状腺症的风险?
José Alberto Vilar Tabanera1, Joaquín Gómez1, Philip Brabyn2
1Department of Surgery, Ramón y Cajal University Hospital, Ctra. Colmenar Viejo, km. 9, 100, Madrid, 28034 Spain.
概括
手术前的维生素D水平可能预测完全甲状腺切除术后的过渡性甲状腺功能低下症. 较低的维生素D水平与短暂的小甲状腺功能障碍症的发病率降低有关,但没有长期或永久的形式.
科学领域:
- 内分泌学 在内分泌学.
- 手术并发症 手术并发症
- 营养科学 营养科学
背景情况:
- 手术后的小甲状腺功能低下症是完全甲状腺切除术后的一个常见并发症.
- 确定手术前预测因素可以帮助管理患有这种并发症风险的患者.
研究的目的:
- 为了研究手术前维生素D水平与完全甲状腺切除术后过渡性,长期和永久性甲状腺功能低下症的发展之间的关联.
主要方法:
- 一项前性观察性研究,涉及100名接受全甲状腺切除术的患者.
- 测量了手术前的维生素D水平,并与手术后的偏偏甲状腺症发病率相关联.
主要成果:
- 在42%的患者中发生过渡性偏偏甲状腺功能障碍,在11%的患者中长期存在,在5%的患者中永久存在.
- 在患有过渡性偏偏甲状腺症的患者中观察到更高的中位数手术前维生素D水平 (24 ng/mL vs. 17 ng/mL).
- 手术前维生素D水平低于20ng/mL的患者出现过渡性副甲状腺功能障碍症的发病率较低 (31.4%对53.1%) 和术后副甲状腺激素 (PTH) 减少较低.
结论:
- 手术前的维生素D缺乏与短暂的小甲状腺功能障碍的较低率和手术后改变的PTH动态有关.
- 在手术前维生素D水平和长期或永久性甲状腺功能低下的发展之间没有发现任何关联.
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