Risk Factors for Severe Hypocalcemia After Thermal Ablation of Secondary Hyperparathyroidism
10.3969/j.issn.1005-5185.2024.06.004
- VernacularTitle:热消融治疗继发性甲状旁腺功能亢进症术后严重低钙血症的危险因素
- Author:
Zhaoyan DENG
1
;
Qiulin LI
;
Xuequn YANG
;
Yingying QIN
;
Yuanxia JIANG
;
Jianguang GAN
Author Information
1. 玉林市第一人民医院肾内科,广西医科大学第六附属医院,广西 玉林 537000
- Keywords:
Ultrasound-guided thermal ablation;
Hyperparathyroidism,secondary;
Severe hypocalcemia;
Risk factors
- From:
Chinese Journal of Medical Imaging
2024;32(6):547-552
- CountryChina
- Language:Chinese
-
Abstract:
Purpose To investigate the risk factors of severe hypocalcemia after ultrasound-guided thermal ablation for secondary hyperparathyroidism.Materials and Methods A retrospective case-control study was used to study 91 patients with uremia complicated with secondary hyperparathyroidism in the First People's Hospital of Yulin from May 2019 to May 2023.All patients underwent ultrasound-guided thermal ablation and were divided into severe hypocalcemia group(SH)and non-SH group according to postoperative blood calcium levels.The difference of clinical data between the two groups was compared,and the independent risk factors of SH were investigated by multivariate Logistic regression analysis.Results A total of 317 glands were ablated in 49 cases of microwave ablation and 42 cases of radiofrequency ablation.SH occurred in 57 cases(62.64%)after ablation.The comparison of clinical data between the two groups showed that there were significant differences in the preoperative intact parathyroid hormone(iPTH),decline rate of iPTH 1 d,preoperative serum alkaline phosphatase,the proportion of parathyroid glands≥4 and the total gland volume between the two groups(all P<0.05).Receiver operating characteristic curve analysis was used to obtain the best cut-off point of iPTH 1 d decline rate,the result was 74.59%,the area under the curve was 0.866(95%CI 0.787-0.945)(P<0.05),the sensitivity was 84.2%,and the specificity was 78.1%.Multivariate Logistic regression analysis showed that preoperative alkaline phosphatase(OR=1.015,95%CI 1.005-1.025,P=0.030)and decline rate of iPTH 1 d≥74.59%(OR=30.423,95%CI 5.938-155.858,P<0.001)and parathyroid glands≥4(OR=4.355,95%CI 1.027-18.469,P=0.046)were independent risk factors for postoperative SH(all P<0.05).Conclusion Preoperative alkaline phosphatase and decline rate of iPTH 1 d≥74.59%and the number of parathyroid glands≥4 are independent risk factors for SH after thermal ablation.
