Pasieka J L, Parsons L L
Department of Surgery, Division of General Surgery, University of Calgary, Calgary, Alberta, Canada.
Surgery. 2000 Oct;128(4):531-9. doi: 10.1067/msy.2000.108117.
To assess the impact of surgery on preoperative symptoms in secondary (2 degrees ) and tertiary (3 degrees ) hyperparathyroidism (HPT) compared with primary (1 degrees ) HPT.
Twenty-two patients with 2 degrees HPT and 10 with 3 degrees HPT were enrolled. Age-matched patients, 32 with 1 degrees HPT and 32 with thyroid disease were enrolled for comparison. An outcome questionnaire documented symptoms expressed as the median symptom index score (MSIS) preoperatively and at days 7 and 3 and 12 months postoperatively.
Preoperatively, the MSIS for the groups with 3 degrees, 2 degrees, and 1 degrees HPT and thyroid disease was 225, 572, 372, and 146, indicating that patients with HPT were more symptomatic than those in the thyroid group (P<.05). Patients with 1 degrees HPT had a decrease in their MSIS at day 7 (195, P<.05) and at 3 and 12 months (159 and 156). Patients with 3 degrees HPT also had a decrease in their MSIS over time. Patients with 2 degrees HPT had a decrease in their MSIS at day 7 (469, P<.05); however, they remained more symptomatic at 3 and 12 months (410 and 355).
Parathyroidectomy reduces many of the preoperative symptoms in HPT. Patients with 1 degrees and 3 degrees HPT have a similar resolution of their symptoms. Patients with 2 degrees HPT have an improvement in many of their symptoms, although they remain more symptomatic at 1 year.
评估手术对继发性（2度）和三发性（3度）甲状旁腺功能亢进症（HPT）术前症状的影响，并与原发性（1度）HPT进行比较。
纳入22例2度HPT患者和10例3度HPT患者。选取年龄匹配的32例1度HPT患者和32例甲状腺疾病患者作为对照。采用结果调查问卷记录术前、术后7天、3个月和12个月以症状指数中位数（MSIS）表示的症状。
术前，3度、2度、1度HPT组和甲状腺疾病组的MSIS分别为225、572、372和146，表明HPT患者比甲状腺疾病组患者症状更明显（P<0.05）。1度HPT患者术后7天（195，P<0.05）、3个月和12个月（159和156）的MSIS下降。3度HPT患者的MSIS也随时间下降。2度HPT患者术后7天MSIS下降（469，P<0.05）；然而，他们在3个月和12个月时仍有更明显的症状（410和355）。
甲状旁腺切除术可减轻HPT的许多术前症状。1度和3度HPT患者的症状缓解情况相似。2度HPT患者的许多症状有所改善，尽管在1年时他们仍有更明显的症状。
