ПРОГНОЗИРОВАНИЕ И ДИАГНОСТИКА МНОЖЕСТВЕННОГО ПОРАЖЕНИЯ ОКОЛОЩИТОВИДНЫХ ЖЕЛЕЗ ПРИ ПЕРВИЧНОМ ГИПЕРПАРАТИРЕОЗЕ МЕТОДОМ МАТЕМАТИЧЕСКОГО АНАЛИЗА

Abstract

Background. Multigland parathyroid disease remains an unresolved problem in endocrine surgery. This is caused by the complexity of clinical and laboratory prediction, insufficient sensitivity of imaging methods and intraoperative monitoring of intact parathyroid hormone. The aim. To develop a predictive scale for multigland parathyroid disease in primary hyperparathyroidism. Materials and methods. We conducted a single-center prospective study which included 126 cases of surgical treat-ment of primary hyperparathyroidism (2019–2021). The main objective of the study was to develop a scale for predicting multigland parathyroid disease in primary hyperparathyroidism using the method of mathematical analysis. Results. The developed scale includes determination of serum levels of albumin-corrected calcium and parathy-roid hormone, glomerular filtration rate, measurement of parathyroid glands parameters according to ultrasound and/or scintigraphy and assessment of the consistency of these results and determination of the KIB coefficient. The results are appraised by points. If the total score is less than 2 points, multigland parathyroid disease is diagnosed; if the total score equals to or more than 2 points – single-gland parathyroid disease. Conclusion. Mathematical prediction of multigland parathyroid disease allows us to clarify the preoperative diagnosis and to plan the scope of surgical treatment.