首页|超声引导下射频消融治疗继发性甲状旁腺功能亢进患者严重低钙血症危险因素分析

超声引导下射频消融治疗继发性甲状旁腺功能亢进患者严重低钙血症危险因素分析

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目的 研究超声引导下射频消融(RFA)治疗继发性甲状旁腺功能亢进(SHPT)患者术后发生严重低钙血症(SH)的危险因素。方法 选取2019年5月至2023年3月在川北医学院附属南充市中心医院接受RFA治疗的41例SHPT患者作为研究对象。采用回顾性分析,收集患者基础信息、疾病信息、实验室及影像学检查等数据。根据患者RFA术后1 d血清校正钙水平是否低于1。8 mmol/L,将患者分为SH组与非SH组,利用单因素、多因素logistic回归模型分析RFA术后发生SH的相关危险因素,绘制受试者工作特征(ROC)曲线检测相关危险因素的预测效能。结果 SHPT患者41例,男19例,女22例,平均年龄(49。56±13。64)岁,RFA术后1 d发生SH者22例(SH组)。单因素分析结果显示,两组患者术前碱性磷酸酶(ALP)、C反应蛋白(CRP)、甲状旁腺激素(PTH)、血钙水平比较差异有统计学意义(P<0。05)。多因素logistic回归分析结果显示,ALP是SHPT患者术后发生SH的独立危险因素。采用ALP预测SHPT患者RFA术后发生SH的ROC曲线下面积(AUC)为0。895,最佳预测截断值为323。34 U/L。结论 关注患者术前ALP水平并合理纠正,有利于降低术后SH发生率。
Analysis on risk factors of severe hypocalcemia in ultrasound-guided radiofrequency ablation treatment in patients with secondary hyperparathyroidism
Objective To investigate the risk factors of postoperative severe hypocalcemia (SH) occur-rence in the patients with secondary hyperparathyroidism (SHPT) treated by ultrasound-guided radiofrequen-cy ablation (RFA).Methods A total of 41 patients with SHPT receiving RFA treatment in the Affiliated Nanchong Central Hospital of North Sichuan Medical College from May 2019 to March 2023 were selected as the study subjects.The retrospective analysis was adopted to collect the data such as the basic information,disease information,laboratory and imagiological examination.The patients were divided into the SH group and non-SH group according to whether or not the corrected serum calcium level being lower than 1.8 mmol/L on 1 d after RFA.The univariate and multivariate logistic regression models were used to analyze the related risk factors of SH occurrence after RFA.The receiver operating characteristic (ROC) curve was drawn to test the predictive efficiency of the related risk factors.Results There were 41 patients with SHPT,inclu-ding 19 males and 22 females,with an average age of (49.56±13.64)years old,and 22 cases developed SH on 1 d after RFA.The univariate analysis results showed that preoperative alkaline phosphatase (ALP),C-reac-tive protein (CRP),parathyroid hormone (PTH) and serum calcium levels had statistical differences between the two groups.The multivariate logistic regression analysis results showed that ALP was an independent risk factor for postoperative SH occurrence.The area under the curve (AUC) of adopting ALP for predicting SH occurrence after RFA in the patients with SHPT was 0.895,and the best predicted cut-off value was 323.34 U/L.Conclusion Paying attention to the level of ALP before operation and correcting it reasonably could be conducive to reduce the incidence rate of postoperative SH.

secondary hyperparathyroidismradiofrequency ablationhypocalcemiasecondary

高言、张嘉欣、覃夏川、谢席胜

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川北医学院附属南充市中心医院肾内科,四川南充 637000

西南医科大学临床医学院,四川泸州 646000

慢性肾脏病基础与临床研究南充市重点实验室,四川南充 637000

继发性甲状旁腺功能亢进 射频消融 低钙血症 继发

2024

重庆医学
重庆市卫生信息中心,重庆市医学会

重庆医学

CSTPCD
影响因子:1.797
ISSN:1671-8348
年,卷(期):2024.53(14)