Caillard Cécile, Sebag Frédéric, Mathonnet Muriel, Gibelin Hélène, Brunaud Laurent, Loudot Coralie, Kraimps Jean-Louis, Hamy Antoine, Bresler Laurent, Charbonnel Bernard, Leborgne Joel, Henry Jean-François, Nguyen Jean-Michel, Mirallié Eric
Department of Digestive and Endocrine Surgery, CHU Nantes, France.
Surgery. 2007 Feb;141(2):153-9; discussion 159-60. doi: 10.1016/j.surg.2006.12.004.
Only a minority of patients with primary hyperparathyroidism (pHPT) present with the "classic" symptoms. Most patients have numerous nonspecific symptoms. The aim of this study was to evaluate patients' quality of life and nonspecific symptoms before and after cure for pHPT.
This prospective, multicentric study, which took place from May 2003 to September 2004, included 100 patients. Six academic departments of Endocrine Surgery in France participated in the study: the University of Angers, Limoges, Nancy, Nantes, Marseille, and Poitiers. Only cured patients were included. All patients were given preoperative and postoperative questionnaires (the SF-36v2 Health Survey) at 3, 6, and 12 months to evaluate quality of life and nonspecific symptoms.
Preoperatively, the main nonspecific symptoms included the following: anxiety (89%); muscular, bone, or join pain (87%); abdominal distention (82%); forgetfulness (81%); headaches (81%); and mood swings (79%). Quality of life was significantly improved at 3 and 6 months (P < .05). At 1 year postoperatively, statistically significant improvement (P < .05) persisted in all 8 domains of the SF-36v2. At 1 year after parathyroidectomy, 5 symptoms remained significantly improved: appetite loss, weight loss, thirst, headache, and nausea.
Operative cure of primary hyperparathyroidism significantly improves quality of life and nonspecific symptoms for at least 1 year.
仅有少数原发性甲状旁腺功能亢进症(pHPT)患者表现出“典型”症状。大多数患者有许多非特异性症状。本研究的目的是评估pHPT患者治愈前后的生活质量和非特异性症状。
这项前瞻性、多中心研究于2003年5月至2004年9月进行,纳入了100例患者。法国6个内分泌外科的学术部门参与了该研究:昂热大学、利摩日大学、南锡大学、南特大学、马赛大学和普瓦捷大学。仅纳入治愈的患者。所有患者在术后3个月、6个月和12个月接受术前和术后问卷调查(SF-36v2健康调查),以评估生活质量和非特异性症状。
术前,主要的非特异性症状包括:焦虑(89%);肌肉、骨骼或关节疼痛(87%);腹胀(82%);健忘(81%);头痛(81%);以及情绪波动(79%)。在术后3个月和6个月时,生活质量有显著改善(P <.05)。术后1年,SF-36v2的所有8个领域均持续存在统计学上的显著改善(P <.05)。甲状旁腺切除术后1年,有5种症状仍有显著改善:食欲减退、体重减轻、口渴、头痛和恶心。
原发性甲状旁腺功能亢进症的手术治愈至少在1年内显著改善了生活质量和非特异性症状。