Effect of ultrasound-guided intraparathyroid injection of vitamin D3 on calcium-phosphorus metabolism and muscle function of patients with hyperparathyroidism associated with Vitamin D deficiency and(or)insufficiency
10.3969/j.issn.1672-8270.2024.03.018
- VernacularTitle:B超引导下甲状旁腺内注射维生素D3对维生素D缺乏相关甲状旁腺功能亢进症患者钙磷代谢及肌肉功能的影响
- Author:
Jing ZHAO
1
;
Jiyun WU
;
Yan XU
Author Information
1. 解放军联勤保障部队第904医院(无锡市太湖医院)肾内科 无锡 214000
- Keywords:
Guidance of ultrasound;
Parathyroid gland;
Vitamin D3;
Hyperparathyroidism associated with vitamin D deficiency and(or)insufficiency;
Calcium-phosphorus metabolism
- From:
China Medical Equipment
2024;21(3):87-92
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of intraparathyroid injection of 1,25 bishydroxyvitamin D3[1,25(OH)2D3]under the guidance of B-mode ultrasound on calcium-phosphorus metabolism and muscle function of patients with hyperparathyroidism associated with vitamin D deficiency and(or)insufficiency.Methods:A total of 60 patients with hyperparathyroidism associated with vitamin D deficiency and(or)insufficiency who were diagnosed at the 904th hospital of People's Liberation Army Joint Service Support Force from January 2020 to June 2022 were selected,and they were divided into observation group and control group according to random number table,with 30 cases in each group.Patients in the observation group received intraparathyroid injection of 1,25(OH)2D3,and those in the control group received oral 1,25(OH)2D3.Before and after 2 weeks of treatment,the characteristics of ultrasound images of two groups were observed,and the calcium-phosphorus level,parathyroid hormone(PTH),alkaline phosphatase(ALP),25 hydroxyvitamin D(25 OHD),1,25(OH)2D3,and urinary calcium(UCa)and urinary phosphorus(UP)at 24h of them were detected.In addition,the skeletal muscle strengths and functions of the two groups were measured.Results:Before treatment,ultrasound images showed the dorsal side of the inferior pole of left lobe of thyroid gland were hypoechoic lesion,and they appeared uniform high enhancement at the arterial phase.After treatment,there was no significant enhancement in the arterial phase of the lesion,which appeared"cavity".The blood calcium levels[(2.06±0.11)mmol/L and(2.21±0.12)mmol/L]of observation group and control group after treatment were significantly higher than those[(1.92±0.02)mmol/L and(1.93±0.03)mmol/L]before treatment,while the blood phosphorus levels[(0.92±0.11)mmol/L and(1.11±0.07)mmol/L]of them after treatment were significantly lower than those[(1.24±0.02)mmol/L and(1.25±0.03)mmol/L]before treatment,and the differences were significant(t=6.859,12.399,15.677,10.069,P<0.05),respectively.Both blood calcium level and blood phosphorus level after treatment of observation group were significantly lower than those of control group,and the differences were statistically significant(t=5.047,7.982,P<0.05),respectively.The PTH and ALP levels of two groups after treatment were significantly lower than those before treatment,and the PTH and ALP levels after treatment of observation group were significantly lower than those of control group,and the differences were statistically significant(t=28.125,12.605,P<0.05),respectively.The blood 25OHD,1,25(OH)2D3 and UCa level at 24 h of two groups after treatment were significantly higher than those before treatment,while the UP level at 24-hour after treatment was lower than that before treatment.The blood 25OHD,1,25(OH)2D3 and UCa at 24 h after treatment in observation group were significantly higher than those in control group,while the UP level at 24h after treatment in observation group was significantly lower than that in control group,with statistical significance(t=9.6763,5.269,45.086,3.387,P<0.05),respectively.The bone density values of L1-4 and femoral neck of two groups after treatment were significantly higher than those before treatment,and the bone density values of L1-4 and femoral neck after treatment in observation group were significantly higher than those in control group,with statistical significance(t=26.944,2.355,P<0.05).The grip strength and walking speed of the skeletal muscles of two groups after treatment were significantly higher than those before treatment,and the above indicators after treatment in the observation group were significantly higher than those in the control group,with statistical significance(t=2.711,3.093,P<0.05),respectively.Conclusion:There will be calcification in the gland of patient with hyperparathyroidism associated with vitamin D deficiency and(or)insufficiency,whose ultrasound appearance is strong echo with different shapes.B-mode ultrasound-guided intraparathyroid injection of 1,25(OH)2D3 can reduce the incidence of fracture.
