СЕРДЕЧНО-СОСУДИСТАЯ ПАТОЛОГИЯ ПРИ БЕССИМПТОМНОМ ПЕРВИЧНОМ ГИПЕРПАРАТИРЕОЗЕ

Паратиреоидный гормон (ПТГ), помимо непосредственной регуляции фосфорно-кальциевого обмена, оказывает влияние на сердечно-сосудистую систему. Рецепторы ПТГ обнаружены в миокарде, гладкомышечных клетках сосудов и клубочковой зоны коры надпочечников. Высокая смертность среди больных с манифестным первичным гиперпаратиреозом (ПГПТ) обусловлена прежде всего сердечно-сосудистыми заболеваниями. В большинстве работ, посвященных проблеме бессимптомного ПГПТ, также затрагиваются вопросы патологии сердечно-сосудистой системы, обусловленные непосредственными эффектами ПТГ. Чаще всего встречаются артериальная гипертензия, гипертрофия миокарда левого желудочка и диастолическая дисфункция, патология комплекса интима-медиа, повышение жесткости сосудов и эндотелиальная дисфункция, также упоминаются кальцинаты и нарушения проводимости. Тем не менее остается нерешенным вопрос причинно-следственных связей, клинической значимости вышеописанных изменений, их влияния на сердечно-сосудистую и общую смертность при бессимптомном ПГПТ, а также их обратимость и снижение смертности после хирургического лечения по поводу бессимптомного ПГПТ. В условиях преобладания бессимптомных форм ПГПТ (часто без абсолютных показаний к хирургическому лечению) представляется особенно актуальной клиническая значимость сердечно-сосудистых осложнений, их влияния на сердечно-сосудистую и общую смертность, а также их обратимость на фоне хирургического лечения.

первичный гиперпаратиреоз, патология околощитовидных желез, сердечнососудистые заболевания, рецепторы паратиреоидного гормона, поражение органов-мишеней

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