Department of Endocrine Surgery, John Radcliffe Hospital, Oxford OX3 9DU, UK.
Langenbecks Arch Surg. 2010 Sep;395(7):941-6. doi: 10.1007/s00423-010-0689-z. Epub 2010 Jul 25.
Parathyroidectomy for primary hyperparathyroidism (PHPT) is followed by a decrease in the severity of symptoms reported on the Pasieka's parathyroid symptoms score (PPSS) and SF-36 questionnaires. Some argue that such benefits are short-lived. This study investigates the severity of symptoms at more than 12 months after parathyroidectomy.
A prospective database collected clinical/operative data on consecutive patients with PHPT. PPSS was calculated as the sum of the 13 parameters self-assessed using a visual analog scale. SF-36(v2) was analyzed using commercially available software (QualityMetric Inc., Lincoln, USA).
Over 3-year interval, 166 patients (119 F/47 M, age 15-89 years) were operated for with PHPT (Ca 2.90 ± 0.25 mmol/L, PTH 21.64 ± 23.05 pmol/L). Their preoperative PPSS ranged 0-1,260 (median 413) and did not correlate with the severity of hypercalcemia. One hundred and seven patients responded when contacted by post at 18 ± 6 months postoperatively. Their postoperative PPSS was significantly lower (398 ± 226 to 231 ± 203, p < 0.001) and in 55 of 107 patients the severity of symptoms reduced by at least 50%. Most significant improvements were for mood (36 ± 33 vs. 16 ± 23), weakness/tiredness (37 ± 32 vs. 17 ± 23), irritability (35 ± 31 vs. 17 ± 21), and thirst (37 ± 32 vs. 18 ± 25; p < 0.0001). Physical and mental component scores of SF-36 questionnaire improved in patients whose PPSS decreased postoperatively.
Symptomatic benefits persist for at least 1 year after parathyroidectomy in the majority of patients with PHPT.
甲状旁腺切除术治疗原发性甲状旁腺功能亢进症 (PHPT) 后，Pasieka 的甲状旁腺症状评分 (PPSS) 和 SF-36 问卷报告的症状严重程度会降低。有人认为这些益处是短暂的。本研究调查了甲状旁腺切除术后超过 12 个月时的症状严重程度。
前瞻性数据库收集了连续 PHPT 患者的临床/手术数据。PPSS 是通过使用视觉模拟量表自我评估的 13 个参数的总和计算得出的。SF-36(v2) 使用商业上可用的软件 (QualityMetric Inc., Lincoln, USA) 进行分析。
在 3 年的时间间隔内，166 名患者（119 名女性/47 名男性，年龄 15-89 岁）接受了 PHPT 手术（Ca 2.90 ± 0.25 mmol/L，PTH 21.64 ± 23.05 pmol/L）。他们的术前 PPSS 范围为 0-1,260（中位数 413），与高钙血症的严重程度无关。107 名患者在术后 18 ± 6 个月通过邮件回复。他们的术后 PPSS 明显较低（398 ± 226 至 231 ± 203，p < 0.001），并且在 107 名患者中有 55 名患者的症状严重程度至少降低了 50%。最显著的改善是情绪（36 ± 33 对 16 ± 23）、虚弱/疲倦（37 ± 32 对 17 ± 23）、易怒（35 ± 31 对 17 ± 21）和口渴（37 ± 32 对 18 ± 25；p < 0.0001）。PPSS 术后降低的患者 SF-36 问卷的身体和心理成分评分均有所提高。
大多数 PHPT 患者在甲状旁腺切除术后至少 1 年仍能获得症状缓解。
