La Justin, Wang Tracy S, Hammad Abdulrahman Y, Burgardt Laura, Doffek Kara, Carr Azadeh A, Shaker Joseph L, Carroll Ty B, Evans Douglas B, Yen Tina W F
Department of Surgery, Medical College of Wisconsin, Milwaukee, WI.
Department of Medicine, Medical College of Wisconsin, Milwaukee, WI.
Surgery. 2017 Jan;161(1):25-34. doi: 10.1016/j.surg.2016.05.047. Epub 2016 Nov 16.
This prospective survey study assessed changes in sleep quality in patients with primary hyperparathyroidism after parathyroidectomy.
Patients undergoing parathyroidectomy for primary hyperparathyroidism (n = 110) or thyroidectomy for benign euthyroid disease (control group; n = 45) were recruited between June 2013 and June 2015 and completed the Pittsburgh Sleep Quality Index preoperatively and at 1- and 6 months postoperatively. "Poor" sleep quality was defined as a score >5; a clinically important and relevant improvement was a ≥3-point decrease.
Preoperatively, parathyroid patients had worse sleep quality than thyroid patients (mean 8.1 vs 5.3; P < .001); 76 (69%) parathyroid and 23 (51%) thyroid patients reported poor sleep quality (P = .03). Postoperatively, only parathyroid patients demonstrated improvement in sleep quality; mean scores did not differ between the parathyroid and thyroid groups at 1 month (6.3 vs 5.3; P = .12) or 6 months (5.8 vs 4.6; P = .11). The proportion of patients with a clinically important improvement in sleep quality was greater in the parathyroid group at 1 month (37% vs 10%; P < .001) and 6 months (40% vs 17%; P = .01). Importantly, there was no difference in the proportion of patients with poor sleep quality between the 2 groups at 1 month (50% vs 40%; P = .32) and 6 months (40% vs 29%; P = .22).
More than two-thirds of patients with primary hyperparathyroidism report poor sleep quality. After parathyroidectomy, over one-third experienced improvement, typically within the first month postoperatively.
这项前瞻性调查研究评估了甲状旁腺切除术后原发性甲状旁腺功能亢进患者的睡眠质量变化。
2013年6月至2015年6月期间,招募了因原发性甲状旁腺功能亢进接受甲状旁腺切除术的患者(n = 110)或因良性甲状腺疾病接受甲状腺切除术的患者(对照组;n = 45),并在术前、术后1个月和6个月完成匹兹堡睡眠质量指数调查。“睡眠质量差”定义为得分>5分;具有临床意义且相关的改善是得分下降≥3分。
术前,甲状旁腺疾病患者的睡眠质量比甲状腺疾病患者差(平均8.1分对5.3分;P <.001);76名(69%)甲状旁腺疾病患者和23名(51%)甲状腺疾病患者报告睡眠质量差(P = 0.03)。术后,只有甲状旁腺疾病患者的睡眠质量有所改善;甲状旁腺疾病组和甲状腺疾病组在术后1个月(6.3分对5.3分;P = 0.12)或6个月(5.8分对4.6分;P = 0.11)时的平均得分没有差异。甲状旁腺疾病组在术后1个月(37%对10%;P <.001)和6个月(40%对17%;P = 0.01)时睡眠质量有临床意义改善的患者比例更高。重要的是,两组在术后1个月(50%对40%;P = 0.32)和6个月(40%对29%;P = 0.22)时睡眠质量差的患者比例没有差异。
超过三分之二的原发性甲状旁腺功能亢进患者报告睡眠质量差。甲状旁腺切除术后,超过三分之一的患者睡眠质量得到改善,通常在术后第一个月内。