Predictive value of parathyroid hormone change rate for the occurrence of hypoparathyroidism after total thyroidectomy
10.3760/cma.j.cn115807-20240104-00003
- VernacularTitle:甲状旁腺素变化率对甲状腺全切除术后甲状旁腺功能减退发生的预测价值
- Author:
Shiyong LIANG
1
;
Yunfang AN
;
Yongjin JI
;
Rong LIU
;
Yanting ZHANG
Author Information
1. 山西医科大学第二医院耳鼻咽喉头颈外科，太原 030001
- Keywords:
Thyroid gland;
Thyroid tumor;
Total thyroidectomy;
Hypoparathyroidism;
Parathyroid hormone
- From:
Chinese Journal of Endocrine Surgery
2024;18(5):679-684
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the predictive value of the change rate of parathyroid hormone (PTH) after total thyroidectomy (TT) for hypoparathyroid function.Methods:A total of 182 patients with thyroid tumor who underwent TT from Jan. 2018 to Jun. 2023 in the Department of Otolaryngology, Head and Neck Surgery, Second Hospital of Shanxi Medical University were retrospectively selected as the study objects. The clinical and surgical data of the patients were collected, and the key factors associated with postoperative hypoparathyroidism were screened by multi-factor analysis. The change rate of serum PTH was calculated during perioperative period (before operation, at the end of operation, 1 and 3 days after operation). Receiver operator curve (ROC) was used to analyze the predictive value of PTH change rate in all patients.Results:Whether temporary hypoparathyroidism (THP) or permanent hypoparathyroidism (PHP), both were closely related to TT+ bilateral central lymph node dissection ( χ2=33.764, 9.235, P < 0.05) and parathyroid resection ( χ2=6.512, 58.999, P < 0.05). The change rate of PTH in HP patients was significantly higher than that in normal patients ( F=15.993, 16.830, 19.024, P < 0.05), and on the first and third day after surgery, the change rate of PTH in PHP patients was significantly higher than that in THP patients ( t=7.955, 9.023, P < 0.05). The predicted area under curve (AUC) of THP or PHP in different patient populations is different with the change rate of PTH in different periods. For patients with TT+ bilateral central lymph node dissection and parathyroidectomy, the change rate of PTH at the end of surgery was significantly higher than the change rate of PTH at 3 days after surgery for the AUC with PHP ( Z=5.433, 4.923, P < 0.05) . Conclusion:Perioperative PTH has good predictive value for THP and PHP in TT patients, especially in TT+ bilateral central lymph node dissection and parathyroidectomy.
