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Abstract：
Parathyroidectomy (PTX) is an effective treatment for primary hyperparathyroidism (PHPT) patients. Postoperative hypocalcemia is a common complication after PTX. This study aimed to analyze the factors influencing serum calcium levels and the incidence of hypocalcemia after parathyroidectomy in primary hyperparathyroidism patients.
The retrospective study included 270 PHPT patients treated with PTX and collected their demographic and clinical information and their laboratory indices. Factors influencing serum calcium levels and hypocalcemia after PTX in PHPT patients were analyzed using univariate and multifactorial analyses.
First, in patients with normal preoperative serum calcium levels (2.20-2.74 mmol/L), the higher the preoperative alkaline phosphatase and serum phosphorus levels, the lower the postoperative serum calcium levels. Furthermore, the higher the preoperative serum calcium levels and the accompanying clinical symptoms, the higher the postoperative serum calcium levels. Low preoperative serum calcium levels were shown to be a risk factor for postoperative hypocalcemia (OR=0.022), and the optimal preoperative serum calcium threshold was 2.625 mmol/L (sensitivity and specificity were 0.587 and 0.712, respectively). Second, in the mild preoperative hypercalcemia group (2.75-3.00 mmol/L), the older the patient, the higher the preoperative and postoperative serum calcium levels, the higher the postoperative serum calcium; the lower the alkaline phosphatase and calcitonin levels, the higher the postoperative serum calcium levels. On the other hand, the younger the patient was, the more likely hypocalcemia blood was (OR=0.947), with an optimal age threshold of 47.5 years (sensitivity and specificity were 0.543 and 0.754, respectively). Third, in the preoperative moderate to severe hypercalcemia group (>3.0mmol/L), patients undergoing a combined contralateral thyroidectomy and a total thyroidectomy had low postoperative serum calcium levels.
Patients with different preoperative serum calcium levels had various factors influencing their postoperative serum calcium levels and postoperative hypocalcemia, which facilitated the assessment of their prognosis.
The retrospective study included 270 PHPT patients treated with PTX and collected their demographic and clinical information and their laboratory indices. Factors influencing serum calcium levels and hypocalcemia after PTX in PHPT patients were analyzed using univariate and multifactorial analyses.
First, in patients with normal preoperative serum calcium levels (2.20-2.74 mmol/L), the higher the preoperative alkaline phosphatase and serum phosphorus levels, the lower the postoperative serum calcium levels. Furthermore, the higher the preoperative serum calcium levels and the accompanying clinical symptoms, the higher the postoperative serum calcium levels. Low preoperative serum calcium levels were shown to be a risk factor for postoperative hypocalcemia (OR=0.022), and the optimal preoperative serum calcium threshold was 2.625 mmol/L (sensitivity and specificity were 0.587 and 0.712, respectively). Second, in the mild preoperative hypercalcemia group (2.75-3.00 mmol/L), the older the patient, the higher the preoperative and postoperative serum calcium levels, the higher the postoperative serum calcium; the lower the alkaline phosphatase and calcitonin levels, the higher the postoperative serum calcium levels. On the other hand, the younger the patient was, the more likely hypocalcemia blood was (OR=0.947), with an optimal age threshold of 47.5 years (sensitivity and specificity were 0.543 and 0.754, respectively). Third, in the preoperative moderate to severe hypercalcemia group (>3.0mmol/L), patients undergoing a combined contralateral thyroidectomy and a total thyroidectomy had low postoperative serum calcium levels.
Patients with different preoperative serum calcium levels had various factors influencing their postoperative serum calcium levels and postoperative hypocalcemia, which facilitated the assessment of their prognosis.
摘要：
■甲状旁腺切除术（PTX）是原发性甲状旁腺功能亢进（PHPT）患者的有效治疗方法。术后低钙血症是PTX术后常见的并发症。本研究旨在分析原发性甲状旁腺功能亢进患者术后血清钙水平及低钙血症发生率的影响因素。
■回顾性研究纳入了270例接受PTX治疗的PHPT患者，并收集了他们的人口统计学和临床信息及其实验室指标。使用单因素和多因素分析分析了影响PHPT患者PTX后血清钙水平和低钙血症的因素。
■首先，术前血清钙水平正常（2.20-2.74mmol/L）的患者，术前碱性磷酸酶和血清磷水平越高，术后血清钙水平越低。此外，术前血清钙水平和伴随的临床症状越高，术后血清钙水平越高。术前血清钙水平低是术后低钙血症的危险因素(OR=0.022),术前血清钙的最佳阈值为2.625mmol/L（敏感性和特异性分别为0.587和0.712）。第二,术前轻度高钙血症组（2.75-3.00mmol/L），病人年龄越大，术前和术后血清钙水平越高，术后血清钙水平越高；碱性磷酸酶和降钙素水平越低，术后血清钙水平越高。另一方面,病人越年轻，低血钙的可能性更大（OR=0.947），最佳年龄阈值为47.5岁(敏感性和特异性分别为0.543和0.754).第三，术前中重度高钙血症组（>3.0mmol/L），接受对侧甲状腺切除术和甲状腺全切除术的患者术后血清钙水平较低.
■不同术前血钙水平的患者,其术后血钙水平和术后低钙血症的影响因素多种多样,这有助于评估他们的预后。
■回顾性研究纳入了270例接受PTX治疗的PHPT患者，并收集了他们的人口统计学和临床信息及其实验室指标。使用单因素和多因素分析分析了影响PHPT患者PTX后血清钙水平和低钙血症的因素。
■首先，术前血清钙水平正常（2.20-2.74mmol/L）的患者，术前碱性磷酸酶和血清磷水平越高，术后血清钙水平越低。此外，术前血清钙水平和伴随的临床症状越高，术后血清钙水平越高。术前血清钙水平低是术后低钙血症的危险因素(OR=0.022),术前血清钙的最佳阈值为2.625mmol/L（敏感性和特异性分别为0.587和0.712）。第二,术前轻度高钙血症组（2.75-3.00mmol/L），病人年龄越大，术前和术后血清钙水平越高，术后血清钙水平越高；碱性磷酸酶和降钙素水平越低，术后血清钙水平越高。另一方面,病人越年轻，低血钙的可能性更大（OR=0.947），最佳年龄阈值为47.5岁(敏感性和特异性分别为0.543和0.754).第三，术前中重度高钙血症组（>3.0mmol/L），接受对侧甲状腺切除术和甲状腺全切除术的患者术后血清钙水平较低.
■不同术前血钙水平的患者,其术后血钙水平和术后低钙血症的影响因素多种多样,这有助于评估他们的预后。
