Objective: To summarize and analyze the diagnostic and therapeutic characteristics of asymptomatic primary hyperparathyroidism (aPHPT). Methods: A retrospective analysis was conducted on the clinical data of 103 patients with aPHPT admitted to the Chinese PLA General Hospital from January 2012 to September 2023. The clinical characteristics, treatment modes, and prognoses of the patients were analyzed. GraphPad Prism 8.0 software was used for statistical analysis. Results: Among the 103 cases, there were 37 males and 66 females, aged from 25 to 78 years, with an average age of (53.81±11.34) years. Ninety-eight cases (95.15%) visited due to abnormal findings during physical examination and 5 cases (4.85%) due to hypertension, diabetes or other diseases. All patients underwent minimally invasive parathyroidectomy with small incision, with 96 cases (93.20%) pathologically diagnosed as adenomas and 7 cases as hyperplasia (6.80%). Postoperative mean serum calcium, parathyroid hormone (PTH) and alkaline phosphatase (ALP) levels were respectively significantly lower than preoperative levels, while postoperative serum phosphorus level was significantly higher than preoperative level (P<0.05). The mean lesion volume was (3.32±6.72)cm3 (range 0.05-49.50 cm3). Patients with different lesion volumes had significant differences in preoperative serum calcium, PTH and ALP levels. Lesion volume was positively correlated to preoperative serum calcium(ρ=0.36, P<0.01), PTH(ρ=0.50, P<0.01) and ALP(ρ=0.39, P<0.01). Among 103 patients, 94 cases were followed up (91.26%), 9 cases were lost (8.74%), and the mean follow-up period was (60.15±29.23) months. The followed-up patients were alive and had no recurrence of lesions or complications, and their blood calcium levels were normal. Conclusion: aPHPT can be preliminarily diagnosed through blood biochemistry and imaging examination, and minimally invasive surgery can offer good prognosis without serious complications.
目的： 探讨无症状原发性甲状旁腺功能亢进（asymptomatic primary hyperparathyroidism，aPHPT）的诊断和治疗特点。 方法： 回顾性分析中国人民解放军总医院自2012年1月至2023年9月收治的aPHPT患者的临床资料，总结患者的临床特点、治疗模式和预后情况，同时计算肿瘤体积，以1、2、3 cm3为界进行分组，计算不同病变体积与血清指标之间的相关性。使用GraphPad Prism 8.0软件对数据进行统计分析。 结果： 入组103例患者，男性37例，女性66例，年龄25~78岁。98例（95.15%）患者因体检发现血生化或影像异常就诊，5例（4.85%）因高血压、糖尿病等疾病就医时检出。全部患者行小切口微创甲状旁腺切除术，病理显示腺瘤96例（93.20%）、增生7例（6.80%）；术后血清钙、甲状旁腺激素（parathyroid hormone，PTH）和碱性磷酸酶（alkaline phosphatase，ALP）均明显低于术前（P值均<0.05），血清磷明显高于术前（P<0.05）；病变体积为（3.32±6.72）cm3，范围为（0.05~49.50）cm3；不同分组病变体积患者术前血清钙、PTH和ALP具有显著差异，病变体积与术前钙（ρ=0.36，P<0.01）、PTH（ρ=0.50，P<0.01）和ALP（ρ=0.39，P<0.01）呈正相关。103例患者中随访94例（91.26%），失访9例（8.74%），随访（60.15±29.23）个月，所有患者无病变复发，无死亡病例以及并发症发生，血钙均正常。 结论： aPHPT可以经血生化及影像检查初步诊断，手术是其主要治疗方法，术后无严重并发症，预后良好。.