Hyperparathyroidism

Hyperparathyroidism yog kev tsis sib haum xeeb hauv cov caj pas parathyroid hauv koj lub caj dab tsim tawm ntau dhau los ntawm parathyroid hormone (PTH).

Muaj 4 leeg me me parathyroid qog nyob rau hauv caj dab, ze lossis txuas rau sab tom qab ntawm lub qog ua haujlwm lub qog.

Parathyroid qog pab tswj kev siv tshuaj calcium thiab tshem tawm los ntawm lub cev. Lawv ua qhov no los ntawm kev tsim cov kab mob parathyroid hormone (PTH). PTH pab tswj cov calcium, phosphorus, thiab cov vitamins D ntau ntxiv hauv cov ntshav thiab pob txha.

Thaum cov qib calcium tsis dhau, lub cev ua haujlwm los ntawm kev ua rau PTH ntau dua. Qhov no ua rau cov qib calcium hauv cov ntshav nce siab.

Thaum ib lossis ntau dua ntawm cov qog ua kab parathyroid loj dua, nws ua rau ntau PTH. Feem ntau, qhov ua rau yog qog benign ntawm parathyroid qog (parathyroid adenoma). Cov hlav hlav no muaj ntau hom thiab tshwm sim yam uas tsis paub tseeb.

• Tus kab mob yog feem ntau rau cov neeg muaj hnub nyoog 60 xyoo, tab sis nws kuj tseem tshwm sim hauv cov neeg hluas hnub nyoog. Hyperparathyroidism thaum yau yog qhov txawv txav.
• Poj niam feem ntau yuav cuam tshuam dua li txiv neej.
• Kev tawg rau lub taub hau thiab caj dab ua rau muaj kev pheej hmoo.
• Qee cov kab mob caj ces (ntau tus kab mob endocrine neoplasia I) ua rau nws muaj feem ntau muaj hyperparathyroidism.
• Hauv qee qhov tsis tshua muaj tshwm sim, tus kabmob yog mob los ntawm parathyroid cancer.

Cov mob uas ua rau muaj cov ntshav qab zib tsawg lossis nce phosphate kuj tseem tuaj yeem ua rau hyperparathyroidism. Cov xwm txheej muaj xws li:

• Cov xwm txheej ua rau nws lub cev tsis tuaj yeem tshem tawm phosphate
• Raum tsis ua haujlwm
• Tsis muaj calcium txaus nyob rau hauv cov khoom noj
• Muaj calcium ntau dhau hauv cov zis
• Kev ntshawv siab Vitamin D (tej zaum yuav tshwm sim hauv cov menyuam uas tsis noj ntau yam zaub mov, thiab cov neeg laus uas tsis muaj hnub ci txaus rau lawv cov tawv nqaij lossis tus uas tsis muaj peev xwm nqus tau cov vitamin D los ntawm cov zaub mov xws li tom qab phais plab)
• Cov teeb meem nqus cov khoom noj los ntawm cov khoom noj

Hyperparathyroidism feem ntau kuaj pom los ntawm kev kuaj ntshav sib txawv ua ntej cov tsos mob tshwm sim.

Cov tsos mob feem ntau tshwm sim los ntawm kev puas tsuaj rau cov plab hnyuv siab raum los ntawm cov calcium uas nyob hauv cov ntshav, lossis los ntawm qhov tsis txaus ntawm cov calcium los ntawm cov pob txha. Cov tsos mob tuaj yeem suav nrog:

• Mob leeg los yog rhiab
• Kev nyuaj siab thiab tsis nco qab
• Ua rau mob siab, mob, thiab qaug zog
• Cov pob txha tawv ntawm nqua thiab nqaj qaum uas tuaj yeem tsoo tau yooj yim
• Cov zis ntau lawm tsim tawm thiab xav tso zis ntau ntxiv
• Raum pob zeb
• Xeev siab thiab tsis qab los noj mov

Tus kws kho mob yuav kuaj ib ce thiab nug txog cov tsos mob.

Kev ntsuam xyuas uas yuav ua tau muaj xws li:

• PTH kuaj ntshav
• Kev kuaj ntshav calcium
• Alkaline phosphatase
• Phus Thas
• Kev kuaj zis 24 teev

Kev yees duab xoo hluav taws xob thiab pob txha ntxhia ceev (DXA) kev kuaj mob tuaj yeem pab tshawb pom pob txha tsis ua, pob txha lov, lossis pob txha.

Kev xoo hluav taws xob, xoo hluav taws xob, lossis CT thaij ntawm lub raum lossis mob txeeb zig yuav qhia tias muaj calcium los yog qhov txhaws.

Ultrasound lossis tshuaj tua kab mob nuclear tsom ntawm caj dab (sestamibi) yog siv los xyuas seb puas muaj cov qog nqaij hlav benign (adenoma) hauv parathyroid caj pas ua rau hyperparathyroidism.

Yog tias koj muaj qib calcium ntau me ntsis thiab tsis muaj cov tsos mob, koj tuaj yeem xaiv mus kuaj mob raws sijhawm lossis tau txais kev kho mob.

Yog koj txiav txim siab kho, nws yuav suav nrog:

• Haus dej kom ntau ntxiv kom tiv thaiv lub raum pob zeb los ntawm txoj kev ua
• Kev tawm dag zog
• Tsis noj hom tshuaj ntsiav dej hu ua thiazide diuretic
• Cov tshuaj estrogen rau cov poj niam uas tau dhau los lawm
• Muaj kev phais kom tshem tawm cov qog overactive

Yog tias koj muaj cov tsos mob lossis koj qib calcium siab heev, koj yuav tsum muaj kev phais mob kom tshem tawm cov qog parathyroid uas ua haujlwm dhau lawm.

Yog tias koj muaj hyperparathyroidism los ntawm ib qho mob, koj tus kws kho mob yuav sau ntawv qhia tshuaj vitamin D, yog tias koj muaj qib vitamin D qis.

Yog tias hyperparathyroidism tshwm sim los ntawm lub raum tsis ua haujlwm, kev kho mob yuav suav nrog:

• Ntxiv rau cov calcium thiab vitamin D
• Tsis txhob noj ntsev rau txoj kev noj haus
• Cov tshuaj cinacalcet (Sensipar)
• Lim ntshav lossis raum hloov ntshav
• Parathyroid phais, yog tias qib parathyroid ua qhov tsis tuaj yeem siab

Outlook yog nyob ntawm qhov ua rau hyperparathyroidism.

Cov teeb meem ntev uas tuaj yeem tshwm sim thaum hyperparathyroidism tsis zoo tswj hwm muaj xws li:

• Cov pob txha ua kom tsis muaj zog, deformed, lossis tuaj yeem tawg
• Ntshav siab thiab mob plawv
• Raum pob zeb
• Mob raum ntev

Parathyroid caj pas phais tuaj yeem ua rau hypoparathyroidism thiab kev puas tsuaj rau cov leeg ntshav uas tswj lub suab.

Parathyroid ntsig txog hypercalcemia; Txha caj qaum - hyperparathyroidism; Cov pob txha mos - hyperparathyroidism; Osteopenia - hyperparathyroidism; Muaj calcium ntau ntxiv - hyperparathyroidism; Mob raum - hyperparathyroidism; Raum tsis ua haujlwm - hyperparathyroidism; Lub zog parathyroid; Vitamin D tsis txaus - hyperparathyroidism

• Parathyroid qog

Hollenberg A, Wiersinga WM. Cov mob hyperthyroid. Hauv: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Phau Ntawv ntawm EndocrinologyCov. Xab 14th. Philadelphia, PA: Elsevier; 2020: chap 12.

Thakker RV. Parathyroid qog, hypercalcemia thiab hypocalcemia. Hauv: Goldman L, Schafer AI, eds. Goldman-Cecil TshuajCov. 26th ed. Philadelphia, PA: Elsevier; 2020: cha 232.