만성신부전증환자에서 부갑상선 절제술 시 수술 중 급속 부갑상선 호르몬 측정의 의의

• 영문명: The Value of Intraoperative Quick Parathyroid Hormone Assay in Patients with Renal Hyperparathyroidism
• 발행기관: 대한내분비외과학회
• 저자명: 김우영 손길수 배정원 구범환 이재복 Woo Young Kim M.D. Gil Soo Son M.D. Jeoung Won Bae M.D. Bum Hwan Koo M.D. and Jae Bok Lee M.D.
• 간행물 정보: 『The Koreran journal of Endocrine Surgery』5권2호, 93~99쪽, 전체 7쪽
• 주제분류: 의약학 > 일반외과학
• 파일형태: PDF
• 발행일자: 2005.12.30

영문 초록

Purpose: Intraoperative quick parathyroid hormone assay (PTH) was introduced in the parathyroid surgery since 1988 and the value in patients with primary hyperparathyroidism was well recognized in the literature. The purpose of this study was to evaluate the usefulness of intraoperative rapid PTH assay in patients with renal hyperparathyroidism by comparing intraoperative PTH results and the biochemical results at postoperative 6^th month, including PTH values. Methods: Fifteen consecutive patients of renal hyperparathyroidism underwent total parathyroidectomy and immediate autotransplantation from November 2003 to February 2005. PTH levels were measured by PTH assay at the induction of anesthesia (baseline level) and in 20-minute intervals after excision of the last parathyroid gland. More than 50% drop of initial PTH level was considered as completeness of parathyroidectomy. Results: Twenty minutes after resection, PTH levels decreased by 83.7% in 14 patients and by 50.2% in one patient. Ten patients (67%) were cured but 5 patients (34%) showed high PTH levels after 6 months. The drop rate of intraoperative quick PTH level in cured patients was 92% at 26 minutes after parathyroidectomy and was significantly different from 73.3% of persistent or recurrent five patients (P=0.047). Preoperative PTH level, calcium level, alkaline phosphatase level and preoperative localization were not different in the cured and recurrent or persistent patients of renal hyperparathyroidism. Conclusion: The value of intraoperative quick PTH assayin patients of renal hyperparathyroidism was questionable. More than 92% drop of intraoperative PTH level at 26 minutes after parathyroidectomy could predict success in our study. (Korean J Endocrine Surg 2005;5:93-99)

키워드

수술 중 급속 부갑상선호르몬 측정법, 신성 부갑상선기능항진증, 부갑상선절제,Intraoperative quick PTH assay, Renal hyperparathyroidism, Parathyroidectomy