[A ten-year follow-up study of a patient with chronic renal failure and metastatic pulmonary calcification after parathyroidectomy and review of the literature].

Objective: To analyze whether parathyroidectomy can prevent the progress of metastatic pulmonary calcification (MPC) in patients with chronic renal failure (CRF). Methods: A male patient with CRF complicated with MPC who underwent parathyroidectomy for secondary hyperparathyroidism and parathyroid adenoma was followed up for 10 years. The changes of MPC and the levels of blood calcium and phosphorus were measured. We searched the relevant literatures in PubMed and Wanfang databases with the key words of "metastatic pulmonary calibration" and "parathyroidectomy". Then, we manually retrieved the references of the literatures. A total of 18 patients (17 patients from 14 publications as well as the present case) were analyzed. By comparing the characteristics of MPC improvement group and MPC progression group, the factors affecting the prognosis of MPC after parathyroidectomy were explored. Results: After parathyroidectomy, the thoracic CT images of the patient gradually worsened from normal to diffuse ground glass opacity of both lungs, which indicated that parathyroidectomy did not prevent the progression of MPC in this patient. Among the 18 MPC patients who underwent parathyroidectomy, 10 patients had improved MPC, three had CRF, and two received peritoneal dialysis or hemodialysis respectively; eight patients had progressed MPC, all of the patients were CRF patients, one patient received peritoneal dialysis, and other patients received hemodialysis. Compared between the two groups, the proportion of CRF patients (P=0.004) and hemodialysis patients (P=0.003) in the progression group were significantly higher than those in the improvement group. Conclusion: Parathyroidectomy cannot prevent the progression of MPC in hemodialysis patients with CRF.目的： 分析甲状旁腺切除术是否可阻止慢性肾功能衰竭（CRF）患者转移性肺钙化（MPC）的进展。 方法： 1例接受血液透析的男性CRF合并MPC患者因继发性甲状旁腺功能亢进和甲状旁腺腺瘤接受了甲状旁腺切除术，术后随访10年，观察MPC及血钙、血磷变化。并分别以metastatic pulmonary calcification和parathyroidectomy、转移性肺钙化和甲状旁腺切除术为检索词，在PubMed和万方数据库中进行检索，并手工搜索相关文献的参考文献，对14篇文献中17例以及本例共18例患者进行分析，通过比较MPC改善组和MPC进展组的相关特点，探讨影响甲状旁腺切除术后MPC转归的因素。 结果： 本例患者接受甲状旁腺切除术后，胸部CT影像由正常逐渐加重为双肺弥漫性磨玻璃影，表明甲状旁腺切除术未能阻止该患者MPC的进展。18例接受甲状旁腺切除术的MPC患者中，术后MPC改善者10例，其中3例存在CRF，2例分别接受腹膜透析、血液透析治疗；进展者8例，均是CRF患者，1例接受腹膜透析，其余患者均接受血液透析治疗。两组比较，进展组CRF患者所占比例（P=0.004）及血液透析患者所占比例（P=0.003）均明显高于改善组。 结论： 甲状旁腺切除术不能阻止CRF血液透析患者MPC进展。.