中华内分泌代谢杂志2023年1月第39卷第1期Chin J Endocrinol Metab,anuary2023,Vol.39,No.11·指南与共识·妊娠合并原发性甲状旁腺功能亢进症多学科诊治专家共识中国研究型医院学会甲状旁腺及骨代谢疾病专业委员会中华医学会围产医学分会中华医学会骨质疏松和骨矿盐疾病分会通信作者：钟慧萍，上海交通大学医学院附属瑞金医院妇产科200025，Email:zhpl0392@rjh.com.cm;廖泉，北京协和医院基本外科100730，Email:lqpume@126.com;刘建民，上海交通大学医学院附属瑞金医院内分泌代谢病科200025，Email:jm10586@jh.com.cn【提要】妊娠合并原发性甲状旁腺功能亢进症（妊娠甲旁亢）是一罕见疾病，可引发母、胎/新生儿多重并发症，加之妊娠的特殊生理改变，使妊娠甲旁亢的诊断、影像学检查和治疗面临困难，需要多学科共同诊治。为提高对妊娠甲旁亢的认识和管理水平，来自全国内分泌科、产科、外科、超声科、核医学科、儿科、肾脏科和全科专业的专家共同讨论，对妊娠甲旁亢诊治过程中的关键点提出共识性建议。【关键词】甲状旁腺功能亢进症：妊娠：高钙血症：共识D0I:10.3760/cma.j.cm311282-20220930-00563Expert consensus on multidisciplinary approach to the diagnosis and treatment of primary hyperparathyroidismin pregnancySociety of Parathyroid and Metabolic Bone Diseases,Chinese Research Hospital Association;Chinese Society of PerinatalMedicine;Chinese Society of Osteoporosis and Bone Mineral ResearchCorresponding authors:Zhong Huiping,Department of Obstetrics and Gynecology,Ruijin Hospital,Shanghai JiaoTong University School of Medicine,Shanghai 200025,China,Email:zhp10392 rih.com.en;Liao Quan,Department of General Surgery,Peking Union Medical College Hospital,Chinese Acndemy of Medicnl Sciences,Beijing100730,China,Email:lqpume@126.com;Liu Jianmin,Department of Endocrine and Metabolic Diseases,RuijinHospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China,Email:ljm10586@rjh.com.en[Summary)Primary hyperparathyroidism in pregnancy is a rare disease,which leads to multiple maternal andfetal/neonatal outcomes.The special physiological changes during pregnancy inflict difficulties on the diagnosis,imaging,and management of this disorder,and require the multi-disciplinary approach.To improve our understandingand management level of primary hyperparathyroidism in pregnancy,experts from departments of endocrinology,obstetrics,surgery,ultrasonography,nuclear medicine,pediatrics,nephrology,and general practice developed aconsensus addressing the key points in the diagnosis and treatment of primary hyperparathyroidism in pregnancy.[Key words]Hyperparathyroidism;Pregnancy;Hypercalcemia;ConsensusD0I:10.3760/cma.j.cn311282-20220930-00563一、前言胰腺炎、肾结石、高血压、子痫前期、死胎、流产以及新妊娠合并原发性甲状旁腺功能亢进症（妊娠甲旁生儿低钙血症、手足搐搦、死亡等多种严重母胎并发症亢)非常少见，尚不清楚其真实发生率。在欧美国家，的风险明显增加山。此外，出于对妊娠期影像学检查妊娠甲旁亢发生率占原发性甲状旁腺功能亢进症和药物使用的顾虑和限制，妊娠甲旁亢的病灶定位和(primary hyperparathyroidism,PHPT)的不到1%，在亚治疗也有一定困难。洲国家差异很大，印度和中国的单中心报道显示其到目前为止，对妊娠甲旁亢的报道多为个例或系分别占PHPT的2.1%(8/386,2005一2020年)[0和列病例报道，或单中心、小样本对照性、回顾性研0.38%(8/2093,2005一2017年)[2。受妊娠期特殊究[2，s刃。对妊娠甲旁亢的诊治仍然以医生的经验性生理改变的影响，妊娠甲旁亢患者高钙血症的临床表处置为主，基于患者的孕周、高钙血症的严重性和风现多样，轻重不一，或不易察觉，易与普通妊娠反应混险-获益比而制定诊疗方案[2，]。虽然妊娠甲旁亢的资裙，给早期发现高钙血症和识别妊娠甲旁亢带来挑料比较零散，但也逐渐勾勒出了该病临床表现及其诊战[34)。妊娠甲旁亢有可能使孕妇出现高钙危象、急性治的各个方面，值得整理汇总。尤其是近年来，国内学
