目的观察甲状旁腺切除术(PTX)对伴有继发性甲状旁腺功能亢进症(Secondary Hyperparathyroidism, SHPT)的血液透析患者钙磷代谢以及动脉钙化、动脉僵硬度情况的影响。方法选取21 例有继发性甲状旁腺功能亢进的血液透析患者，行甲状旁腺切除术，对患者术前、术后1 年应用多层螺旋CT检测冠状动脉钙化积分，并测臂踝脉搏波传导速度(baPWV)，同时将患者术前、术后1 年的血钙、血磷、钙磷乘积、PTH 等指标进行比较。结果与术前比较，术后1 年患者冠状动脉钙化积分有明显减低(P=0.0236)，左右两侧肢体臂踝脉搏波传导速度(baPWV)平均值减少(P=0.0034, P=0.0012)，差异性有统计学意义；术后血钙、血磷、钙磷乘积、PTH 水平均明显降低，差异性有统计学意义(P 分别为0.0004,0.0002,0.0000,0.0000)。结论甲状旁腺切除术(pTx)能纠正钙磷代谢紊乱，减轻动脉钙化程度，改善动脉僵硬度。

【Abstract】Objective To observe the impact of parathyroidectomy (PTX) on calcium and phosphorus metabolism, arterial calcification and arterial stiffness in maintenance hemodialysis (MHD) patients complicated with secondary hyperparathyroidism (SHPT). Methods A total of 21 MHD patients with SHPT were subjected to PTX. Their coronary artery calcification score based on the multi-slice spiral CT images, brachial-ankle pulse wave velocity (baPWV), serum calcium, phosphorus, calcium-phosphorus product, and serum PTH were compared before PTX and after PTX for one year. Results After PTX for one year, coronary artery calcification score decreased significantly (P=0.0236), so did the mean baPWVs of bilateral limbs (P=0.0034 and 0.0012 for left and right limbs, respectively), as compared with those before PTX. Serum calcium, phosphorus, calcium-phosphorus product, and PTH also reduced after PTX (P=0.0004, 0.0002, <0.0001 and <0.0001, respectively). Conclusions PTX improved calcium and phosphorus metabolism, and reduced arterial calcification and stiffness in MHD patients with SHPT.