Role of parathyroid hormone measurement in prediction for symptomatic hypocaleaemia after total thyroidectomy
10.3760/cma.j.issn.1673-0860.2010.03.011
- VernacularTitle:甲状旁腺素检测对甲状腺全切除后低钙症状的诊断价值
- Author:
Chang-Ming AN
1
;
Ping-Zhang TANG
;
Zhen-Gang XU
;
Bin ZHANG
;
Zong-Min ZHANG
;
Dan-Gui YAN
;
Zheng-Jiang LI
Author Information
1. 中国医学科学院肿瘤医院
- Keywords:
Thvroidectomy;
Parathyroid hormone;
Hypocalcemia
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2010;45(3):217-221
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the role of parathyroid hormone(PTH)and serum calcium in prediction for hypocalcaemia after total thyroidectomy.Methods One hundred and sixty-five patients undergoing total or complete total thyroidectomy were reviewed retrospectively.The indications included bilateral carcinoma,undifferential carcinoma,surroundings invasion,distant metastasis and huge benign lesions.Preoperative and postoperative PTH,calcium concentrations and their decline levels were compared between Jan.2005 and May 2009.The role of PTH valne and decline level predicting for symptomatic hvpocalcaemia were analyzed by receiver operator characteristics(ROC)curve.Results After total thyroidectomy,85 patients(51.5%)developed hypocalcemia.Symptoms were reported by 36 patients (21.8%).The mean concentration of PTH for normocalcaemia(80 cases),asymptomatic hypocalcaemia (49 cases)and symptomatic patients(36 cases)were 31.0 ng/L,19.6 ng/L and 11.9 ng/L,respectively.The mean decline level for the three groups were 28.6%,52.6% and 78.0%,respectively.PTH value and its decline level had a poor predicting value for symptomatic hypocalcaemia and high negative predicting value for asymptomatic patients.The serum calcium concentration more than 2.0 mmoL/L,PTH level higher than 15 ng/L and PTH decline les8 than 50% had the good negative predicting value of 97.6%,90.3% and 96.5%.respectively.Conclusions Postoperative PTH and its decline level were significantly correlated with postoperative serum calcium concentration but had a low accuracy for predicting symptomatic hypocalcaemia.The serum calcium concentration more than 2.0 mmol/L,PTH level higher than 15 ng/L and PTH decline less than 50% had the good predicting value for asymptomatic patients.Calcium should be routinely supplemented in the first 24 h after total thyroidectomy to reduce the rate of hypocalcemia and the severity of hypocalcemia symptoms.
