Objective To explored the correlation between levels of serum calcium, phosphorus PTH and 99Tc m-MIBI in patients with hyperparathyropathy as well as to find cut off valve of serum calcium, phosphorus and PTH. Methods A total of 234 patients with hyperparathyroidism that confirmed by operation and pathology were collected from September 2017 to September 2019. Results The median PTH levels in PHPT group and SHPT group were 210.93 (122.60~529.20) pg/ml and 1 842.50 (1 342.50~2 345.00) pg/ml, respectively. There was significant difference between the two groups ( Z = −10.83, P = 0.000). SHPT group was significantly higher than that in PHPT group. The median of Ca level of PHPT group and SHPT group was 2.86 (2.65~3.15) mmol/L and 2.43 (2.32~2.58) mmol/L, respectively. There was significant difference between the two groups ( Z = −7.52, P = 0.000). The level of Ca in PHPT group was significantly higher than that in SHPT group. The median of P level in PHPT group and SHPT group was 0.80 (0.64~1.03) mmol/L and 2.26 (1.97~2.63) mmol/L respectively. There was significant difference between the two groups ( Z = −10.15, P = 0.000), and the PHPT group was significantly lower than the SHPT group. The age, gender, PTH and Ca and P value were taken as independent variables, and the results of MIBI imaging were used as dependent for logistic regression analysis. After screening, the influencing factor of PHPT group was PTH value ( OR: 1.012, 95% CI: 1.002~1.023), and correlation analysis showed that r = 0.60 ( P = 0.000). No related factors were found in SHPT group. ROC curves of 99Tc m-MIBI imaging results in PHPT group were drawn, corresponding to the areas under the maximum curve of 0.91, and the calculated cutoff value was 113.1 pg/mL. simple scatter plot of Ca value, P value and PTH value was drawn in PHPT group and SHPT group, and correlation analysis was performed. Tn PHPT group, Ca value and PTH value had moderate correlation ( r = 0.64, P = 0.000), P value and PTH value had low correlation ( r = −0.28, P = 0.032); in SHPT group: Ca value and PTH value had low correlation ( r = 0.17, P = 0.03), P value and PTH value had no correlation ( P = 0.15). Conclusion The serum PTH level of PHPT was moderately correlated with MIBI imaging results. The higher the serum PTH level, the higher the positive rate of MIBI imaging, and the corresponding cutoff value of MIBI imaging was 113.1 pg/mL. There was a moderate correlation between serum Ca level and serum PTH level in PHPT, while in SHPT group low correlation between serum Ca level and serum PTH level. 摘要: 目的 探讨甲状旁腺功能亢进症患者血清钙、磷、甲状旁腺激素 (PTH) 水平与 99Tc m-MIBI 显像的相关性, 计算 血清钙、磷和 PTH 的 Cut-off 值。 方法 回顾性分析 2017 年 9 月一2019 年 9 月经手术病理学确诊的甲状旁腺功能亢 进患者 234 例, 所有患者均于术前行甲氧基异丁基异腈 (MIBI) 显像和血清 PTH、钙、磷等生化检查。 结果 原发性 (PHPT) 和继发性 (SHPT) 甲状旁腺功能亢进者 PTH 水平中位数分别为 210.93(122.60~529.20) pg/mL 和 1 842.50 (1 342.50~2 345.00) pg/mL, 两组间差异有统计学意义 ( Z = −10.83, P = 0.000), SHPT 组显著高于 PHPT 组。PHPT 组和 SHPT 组血清钙水平中位数分别为 2.86(2.65~3.15) mmoL/L 和 2.43(2.32~2.58) mmoL/L, 两组间差异有统计学 意义 ( Z = −7.52, P = 0.000), PHPT 组显著高于 SHPT 组。PHPT 组和 SHPT 组血清磷水平中位数分别为 0.80(0.64~ 1.03) mmoL/L 和 2.26(1.97~2.63) mmoL/L, 两组间差异有统计学意义 ( Z = −10.15, P = 0.000), PHPT 组显著低于 SHPT 组。将年龄、性别、PTH 值、钙值、磷值作为自变量, MIBI 显像结果作为应变量, Logistic 回归分析得出 PTH 值 为 PHPT 组的影响因素 ( OR: 1.012, 95% CI: 1.002~1.023), 相关性分析得出 r = 0.60 ( P = 0.000); SHPT 组无相关因 素。绘制 PHPT 组 99Tc m-MIBI 影像显像结果 ROC 曲线, 对应最大曲线下面积 0.91, 计算 Cut-off 值为 113.1 pg/mL。 绘制 PHPT 组和 SHPT 组钙值、磷值与 PTH 值散点图, 相关性分析得出 PHPT 组:钙值与 PTH 值具有中度相关 ( r = 0.64, P = 0.000), 磷值与 PTH 值具有低度相关 ( r = −0.28, P = 0.032); SHPT 组:钙值与 PTH 值具有低度相关 ( r = 0.17, P = 0.03), 磷值与 PTH 值无相关性 ( P = 0.15)。 结论 PHPT 组血清 PTH 水平与 MIBI 显像结果具有中度相关 性, 血清 PTH 水平越高 MIBI 显像阳性率越高, MIBI 显像对应的分界值为 113.1 pg/ml。PHPT 组血清Ca水平与血清 PTH 水平具有中度相关性, 而 SHPT 组血清 Ca 水平与血清 PTH 水平具有低度相关性。