张涛静 吴淑馨 谢培凤

    [摘要] Graves病为自身免疫性甲状腺病，以甲状腺功能亢进症(简称“甲亢”)为主要表现，常表现为高代谢状态，并影响骨代谢，但临床上由于甲亢影响骨代谢，进而引发继发性甲状旁腺功能亢进症的却非常罕见。本文报道了1例Graves病诊断1个月后发生全身肌肉抽搐，经过详细检查发现甲状旁腺素(PTH)升高，最终明确诊断为继发性甲状旁腺功能亢进症。复习相关文献发现针对甲亢与PTH关系的研究基本都为单中心、非盲法研究，病例数较小，得出的结论也不一致。通过本病例报道，提示对于甲亢患者应提高警惕，常规检查PTH和血清游离钙水平，对于存在游离钙水平低、PTH水平高的患者，应提前补充钙片，预防骨质疏松发生。

    [关键词] Graves病；继发性甲状旁腺功能亢进症；甲状旁腺素

    [中图分类号] R581.1 [文献标识码] A [文章编号] 1673-7210(2016)10(b)-0165-03

    [Abstract] Graves disease is an autoimmune thyroid disease. The hyperthyroidism is its main performance， usually with high metabolic state and affecting bone metabolism. However clinically it is very rare that hyperthyroidism affects bone metabolism and lead to secondary hyperparathyroidism. This paper reports one cases of Graves disease. The patient had the muscles twitch after one month of diagnosis. The final diagnosis is secondary hyperparathyroidism after a detailed examination with elevated PTH. Review of the literature find that researches on the relationship between hyperthyroidism and PTH are basically single center， non-blinded study with a small number of cases. The conclusion is also inconsistent. This this case report prompts that patients with hyperthyroidism should be vigilant ......