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慢性病中的二次性甲状腺功能障碍症:一个叙事性综述,重点关注治疗策略
Shin-Hwa Tsai1, Wei-Chih Kan2, Rong-Na Jhen3
1Department of Internal Medicine, National Taiwan University Hospital, No.7, Zhongshan S. Rd., Zhongzheng Dist., Taipei City, 100225, Taiwan, ROC.
Clinical medicine (London, England)
|August 29, 2024
概括
在慢性病 (CKD) 中的二次性甲状腺功能障碍症 (SHPT) 管理涉及酸盐结合剂,维生素D和仿药. 副甲状腺切除术和热切除术为耐火性SHPT提供了有效的侵入性选择.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 内分泌学 在内分泌学.
背景情况:
- 慢性病 (CKD) 影响全球人口的10%以上.
- 二次性偏甲状腺症 (SHPT) 是CKD的一个常见并发症,由功能受损导致高酸血症,低血症和低活性维生素D.
- SHPT显著增加了骨病,血管化,心血管事件和死亡率的风险.
研究的目的:
- 审查慢性病 (CKD) 患者的二次性甲状腺功能增强症 (SHPT) 目前的治疗策略.
- 为了比较SHPT医疗和侵入性治疗选择的疗效.
主要方法:
- 在CKD患者中对SHPT治疗策略的文献综述.
- 对一线医学疗法的分析:酸盐结合剂,维生素D受体激活剂和仿药.
- 侵袭性选择的评估:副甲状腺切除术 (PTX) 和最小侵袭性热切除术技术 (微波,射频,激光,高强度聚焦超声波).
主要成果:
- 第一线医疗治疗是CKD中SHPT的标准.
- 副甲状腺切除术 (PTX) 在减少SHPT症状,改善放射学结果,降低心血管风险和死亡率方面表现出有效性,与单独治疗药物相比.
- 热除技术为PTX提供了有希望的,不那么侵入性的替代品.
结论:
- SHPT是CKD的一个关键并发症,需要有效的管理.
- 副甲状腺切除术为耐火性SHPT提供了显著的好处,包括改善心血管结果.
- 最少侵入性热性除是CKD中SHPT的新兴治疗选择.
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