bmjourБайкальский медицинский журналBaikal Medical Journal2949-0715Irkutsk State Medical University10.57256/2949-0715-2022-1-50-56bmjour-23Research ArticleОригинальные статьиOriginal articlesПРОГНОЗИРОВАНИЕ И ДИАГНОСТИКА МНОЖЕСТВЕННОГО ПОРАЖЕНИЯ ОКОЛОЩИТОВИДНЫХ ЖЕЛЕЗ ПРИ ПЕРВИЧНОМ ГИПЕРПАРАТИРЕОЗЕ МЕТОДОМ МАТЕМАТИЧЕСКОГО АНАЛИЗАPREDICTION AND DIAGNOSIS OF SPORADIC MULTIGLANDULAR PARATHYROID DISEASE BY THE METHOD OF MATHEMATICAL ANALYSIShttps://orcid.org/0000-0002-2081-8665ИльичеваЕлена АлексеевнаIlyichevaE.A.

доктор медицинских наук, профессор, заведующая научным отделом клинической хирургии, ФГБНУ «Иркутский научный центр хирургии и травматологии»

lena_isi@mail.ruhttps://orcid.org/0000-0002-6887-8325БерсеневГлеб АлександровичBersenevG.A.

аспирант научного отдела клинической хирургии, ФГБНУ «Иркутский научный центр хирургии и травматологии»

glbersenev17@gmail.comФГБНУ «Иркутский научный центр хирургии и травматологии»РоссияIrkutsk Scientific Centre of Surgery and TraumatologyRussian Federation202210122022115056Copyright © Ильичева Е.А., Берсенев Г.А., 20222022Ильичева Е.А., Берсенев Г.А.Ilyicheva E., Bersenev G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.bmjour.ru/jour/article/view/23Введение

Введение. Множественное поражение околощитовидных желез при первичном гиперпаратиреозе  остается нерешенной проблемой в эндокринной хирургии.  Это связано со сложностью клинико-лабораторного прогнозирования, недостаточной чувствительностью методов визуализации и интраоперационного мониторинга интактного паратиреоидного гормона.

Цель исследования

Цель исследования: разработка прогностической шкалы множественного поражения околощитовидных желез при первичном гиперпаратиреозе. Материалы   и   методы. Проведено одноцентровое проспективное исследование, включающее 126 наблюдений хирургического лечения первичного гиперпаратиреоза (2019-2021 гг.) Задачей исследования была разработка шкалы прогнозирования множественного поражения околощитовидных желез при первичном гиперпаратиреозе методом математического анализа.

Результаты

Результаты. Разработанная шкала включает определение в сыворотке крови уровней альбумин-скорректированного кальция и паратиреоидного гормона, скорости клубочковой фильтрации, измерение параметров околощитовидных желез по данным ультразвукового исследования и/или сцинтиграфии  с оценкой согласованности этих результатов и  определение величины коэффициента КIB. Результаты оцениваются в баллах. При сумме баллов меньше 2-х диагностируют множественное поражение ОЩЖ, равной или больше 2-х – одной железы.

Заключение

Заключение. Математическое прогнозирование множественного поражения околощитовидных желез при первичном гиперпаратиреозе позволяет уточнить дооперационный диагноз и планировать объем оперативного лечения.

Background

Background. Sporadic multiglandular parathyroid disease remains an unresolved problem in endocrine surgery. This is due to the complexity of clinical and laboratory prediction, insufficient sensitivity of imaging methods and intraoperative monitoring of intact parathyroid hormone.

Аim is to develop a predictive scale for multiple lesions of the parathyroid glands in primary hyperparathyroidism.

Materials and methods

Materials and methods. A single-center prospective study was conducted, including 126 cases of surgical treatment of primary hyperparathyroidism (2019-2021). The main endpoint of the study was to develop a scale for predicting multiple PTG lesions in PHPT using the method of mathematical analysis.

Results

Results. The developed scale includes determination of serum levels of albumin-corrected calcium and parathyroid hormone, glomerular filtration rate (GFR), measurement of parathyroid glands parameters according to ultrasound and/or scintigraphy and assessment of the consistency of these results and determination of the value of the coefficient KIB. The results are evaluated in points. If the total score is less than 2, multiglandular parathyroid disease is diagnosed, equal to or more than 2 - one gland.

Conclusion

Conclusion. Mathematical prediction of sporadic multiglandular parathyroid disease allows clarifying the preoperative diagnosis and planning the scope of surgical treatment.

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The authors declare that there are no conflicts of interest present.