科研之友
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摘要
introduction: indiscriminate serum calcium measurement may lead to the identification of asymptomatic patients with hypercalcaemia, which is caused mostly by primary hyperparathyroidism. objective: to discuss the frequency of hypercalcaemia and the type of assessment of this condition in an outpatient population, with emphasis on the investigation of primary hyperparathyroidism. material and methods: in a prospective study 1,049 subjects (age range: 40 to 60 years old) underwent serum calcium and albumin determination and the corrected calcium values were calculated. when there was a rise in the corrected calcium level, ionized calcium, phosphate, parathyroid hormone (pth) and urinary calcium were measured. results: the average age was 49.7 ㊣ 13.7 years old, and 188 subjects (17.9%) had elevated corrected calcium levels. among these, 90 patients underwent the second investigation and 19 (2%) remained hypercalcemic. ionized calcium levels (average: 1.2 ㊣ 0.01 mmol/l) were normal in all subjects. urinary calcium was 185.8 ㊣ 111.8 mg/24 hours. pth levels (average: 46 ㊣ 11.8 pg/ml) were elevated in three subjects whose parathyroid scintigraphies were normal. discussion: the fall in the frequency of hypercalcaemia based on corrected serum calcium levels and mostly after determination of serum ionized calcium suggests that determinations of serum free calcium are a better screening test. no subject was diagnosed with hyperparathyroidism, what suggests an uneven distribution of the disease in different populations. conclusion: routine serum calcium determinations in asymptomatic patients must be questioned. when serum calcium determination is thought necessary, ionized calcium levels should be favored.
