原发性甲状旁腺功能亢进症是一种相对常见的疾病,在年龄大于 40 岁的人群中,女性患病率 1/500,男性为 1/2000。一项基于人群的研究显示,2% 的绝经后的女性患有 PHPT,是引起门诊高钙血症患者的最常见疾病。[7]Lundgren E, Hagström EG, Lundin J, et al. Primary hyperparathyroidism revisited in menopausal women with serum calcium in the upper normal range at population-based screening 8 years ago. World J Surg. 2002 Aug;26(8):931-6.http://www.ncbi.nlm.nih.gov/pubmed/12045863?tool=bestpractice.com PHPT 和恶性肿瘤是导致绝大多数患者高血钙症的原因。
在二十世纪七十年代,随着包含有检测血钙水平的多通道分析仪的广泛日常使用,美国 PHPT 的发病率显著上升。从七十年代后,发病率下降,其原因多数未明。[8]Wermers RA, Khosla S, Atkinson EJ, et al. Incidence of primary hyperparathyroidism in Rochester, Minnesota, 1993-2001: an update on the changing epidemiology of the disease. J Bone Miner Res. 2006 Jan;21(1):171-7.http://www.ncbi.nlm.nih.gov/pubmed/16355286?tool=bestpractice.com 1998 年至 2010 年期间,美国的年发病率估计为 50/100,000 人年。[9]Yeh MW, Ituarte PH, Zhou HC, et al. Incidence and prevalence of primary hyperparathyroidism in a racially mixed population. J Clin Endocrinol Metab. 2013 Mar;98(3):1122-9.http://www.ncbi.nlm.nih.gov/pubmed/23418315?tool=bestpractice.com[10]Griebeler ML, Kearns AE, Ryu E, et al. Secular trends in the incidence of primary hyperparathyroidism over five decades (1965-2010). Bone. 2015 Apr;73:1-7.http://www.ncbi.nlm.nih.gov/pubmed/25497786?tool=bestpractice.com 患病率合理估计约为 1/1000。[8]Wermers RA, Khosla S, Atkinson EJ, et al. Incidence of primary hyperparathyroidism in Rochester, Minnesota, 1993-2001: an update on the changing epidemiology of the disease. J Bone Miner Res. 2006 Jan;21(1):171-7.http://www.ncbi.nlm.nih.gov/pubmed/16355286?tool=bestpractice.com[11]Boonstra CE, Jackson CE. Serum calcium survey for hyperparathyroidism: results in 50,000 clinic patients. Am J Clin Pathol. 1971 May;55(5):523-6.http://www.ncbi.nlm.nih.gov/pubmed/5090209?tool=bestpractice.com 尽管该疾病会影响各年龄组,但如果不存在遗传综合征,在 20 岁前患病者少见。该病在 50 到 60 岁女性中最为常见,女性发病率是男性的 2-3 倍。[1]Wilhelm SM, Wang TS, Ruan DT, et al. The American Association of Endocrine Surgeons guidelines for definitive management of primary hyperparathyroidism. JAMA Surg. 2016;151:959-968.http://jamanetwork.com/journals/jamasurgery/fullarticle/2542667http://www.ncbi.nlm.nih.gov/pubmed/27532368?tool=bestpractice.com[12]Silverberg SJ, Bilezikian JP. The diagnosis and management of asymptomatic primary hyperparathyroidism. Nat Clin Pract Endocrinol Metab. 2006 Sep;2(9):494-503.http://www.ncbi.nlm.nih.gov/pubmed/16957763?tool=bestpractice.com 全球发病率和患病率与美国相似,但临床表现存在很大差异。在美国和欧洲,大部分 (80%) 患者无症状,但在资源贫瘠的国家,大部分 (>80%) 患者有症状。[2]Khan AA, Hanley DA, Rizzoli R, et al. Primary hyperparathyroidism: review and recommendations on evaluation, diagnosis, and management. A Canadian and international consensus. Osteoporos Int. 2017;28:1-19.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5206263/http://www.ncbi.nlm.nih.gov/pubmed/27613721?tool=bestpractice.com[12]Silverberg SJ, Bilezikian JP. The diagnosis and management of asymptomatic primary hyperparathyroidism. Nat Clin Pract Endocrinol Metab. 2006 Sep;2(9):494-503.http://www.ncbi.nlm.nih.gov/pubmed/16957763?tool=bestpractice.com