Walker Marcella D, McMahon Donald J, Inabnet William B, Lazar Ronald M, Brown Ijeoma, Vardy Susan, Cosman Felicia, Silverberg Shonni J
Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA.
J Clin Endocrinol Metab. 2009 Jun;94(6):1951-8. doi: 10.1210/jc.2008-2574. Epub 2009 Mar 31.
Data regarding the presence, extent, and reversibility of psychological and cognitive features of primary hyperparathyroidism (PHPT) are conflicting.
This study evaluated psychological symptoms and cognitive function in PHPT.
This is a case-control study in which symptoms and their improvement 6 months after surgical cure of PHPT were assessed.
The study was conducted in a university hospital metabolic bone disease unit and endocrine surgery practice.
Thirty-nine postmenopausal women with PHPT and 89 postmenopausal controls without PHPT participated in the study.
Participants with PHPT underwent parathyroidectomy.
Measurements used in the study were: Beck Depression Inventory (BDI); State-Trait Anxiety Inventory, Form Y (STAI-Y); North American Adult Reading Test (NAART); Wechsler Memory Scale Logical Memory Test, Russell revision (LM); Buschke Selective Reminding Test (SRT); Rey Visual Design Learning Test (RVDLT); Booklet Category Test, Victoria revision (BCT); Rosen Target Detection Test (RTD); Wechsler Adult Intelligence Scale-Revised Digit Symbol Subtest (DSy); Wechsler Adult Intelligence Scale Digit Span Subtest (DSpan).
At baseline, women with PHPT had significantly higher symptom scores for depression and anxiety than controls and worse performance on tests of verbal memory (LM and SRT) and nonverbal abstraction (BCT). Depressive symptoms, nonverbal abstraction, and some aspects of verbal memory (LM) improved after parathyroidectomy to the extent that scores in these domains were no longer different from controls. Baseline differences and postoperative improvement in cognitive measures were independent of anxiety and depressive symptoms and were not linearly associated with serum levels of calcium or PTH.
Mild PHPT is associated with cognitive features affecting verbal memory and nonverbal abstraction that improve after parathyroidectomy.
关于原发性甲状旁腺功能亢进症（PHPT）心理和认知特征的存在、程度及可逆性的数据相互矛盾。
本研究评估了PHPT患者的心理症状和认知功能。
这是一项病例对照研究，评估了PHPT手术治愈6个月后症状及其改善情况。
该研究在一家大学医院的代谢性骨病科和内分泌外科进行。
39名绝经后PHPT女性和89名无PHPT的绝经后对照者参与了研究。
PHPT参与者接受了甲状旁腺切除术。
本研究中使用的测量指标包括：贝克抑郁量表（BDI）；状态-特质焦虑量表Y型（STAI-Y）；北美成人阅读测试（NAART）；韦氏记忆量表逻辑记忆测试（罗素修订版，LM）；布施克选择性提醒测试（SRT）；雷伊视觉设计学习测试（RVDLT）；手册分类测试（维多利亚修订版，BCT）；罗森目标检测测试（RTD）；韦氏成人智力量表修订版数字符号分测验（DSy）；韦氏成人智力量表数字广度分测验（DSpan）。
基线时，PHPT女性的抑郁和焦虑症状评分显著高于对照组，在言语记忆测试（LM和SRT）和非言语抽象测试（BCT）中的表现更差。甲状旁腺切除术后，抑郁症状、非言语抽象能力以及言语记忆的某些方面（LM）有所改善，这些领域的得分与对照组不再有差异。认知测量的基线差异和术后改善与焦虑和抑郁症状无关，且与血清钙或甲状旁腺激素水平无线性关联。
轻度PHPT与影响言语记忆和非言语抽象能力的认知特征相关，甲状旁腺切除术后这些特征会改善。
