继发性甲状旁腺功能亢进(secondary hyperparathyroidism，SHPT)是慢性肾脏病，尤其是终末期肾病患者的常见严重并发症。甲状旁腺激素1型受体(parathyroid hormone type 1 receptor，PTH1R)作为调控钙磷代谢的核心靶点，已成为新型疗法研发的热点。与传统肽类药物相比，抗体类药物具有高亲和力、高特异性和可工程化修饰等优势。拮抗型PTH1R抗体可有效阻断甲状旁腺激素/甲状旁腺激素相关肽信号通路，在SHPT动物模型中显示出降低血甲状旁腺激素、血磷及减轻甲状旁腺增生的潜力。本文基于近期国内外相关文献，系统分析PTH1R的生物学功能、在SHPT中的作用机制、抗体(特别是纳米抗体)筛选的技术优势(如噬菌体展示技术)，旨在综述靶向PTH1R治疗性抗体的功能特性及其在SHPT治疗中的潜在应用价值。未来研究需聚焦于抗体的人源化改造、长效化设计及在动物模型中的验证，以推动其临床转化。

Secondary hyperparathyroidism (SHPT) represents a prevalent and severe complication in patients with chronic kidney disease, particularly in patients with end‑stage renal disease. The parathyroid hormone type 1 receptor (PTH1R), as a core target regulating calcium‑phosphorus metabolism, has become a hotspot in the development of novel therapeutics. Compared with traditional peptide‑based drugs, antibody‑based agents offer advantages such as high affinity, high specificity, and potential for engineering modifications. Antagonistic PTH1R antibodies can effectively block the parathyroid hormone/parathyroid hormone‑related peptide signaling pathway and have demonstrated efficacy in SHPT animal models by reducing serum parathyroid hormone and phosphorus levels, as well as alleviating parathyroid hyperplasia. Based on recent domestic and international literature, this review systematically analyzes the biological functions of PTH1R, its mechanisms in SHPT, and the technical advantages of antibody (particularly nanobody) screening approaches such as phage display technology. The aim is to summarize the functional properties of therapeutic antibodies targeting PTH1R and their potential application value in SHPT treatment. Future research should focus on antibody humanization, long‑acting design, and validation in animal models to facilitate clinical translation.