Storvall Sara, Ryhänen Eeva M, Heiskanen Ilkka, Sintonen Harri, Roine Risto P, Schalin-Jäntti Camilla
Endocrinology, Abdominal Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Department of Public Health, University of Helsinki, Helsinki, Finland.
Horm Metab Res. 2017 Oct;49(10):772-777. doi: 10.1055/s-0043-118347. Epub 2017 Sep 18.
Surgery for primary hyperparathyroidism (PHPT) improves health-related quality of life (HRQoL), but it is unclear whether the effects are sustained after medium-term (>2 years) follow-up, and whether the results on some or all dimensions of HRQoL will reach that of the general population. We performed a follow-up of HRQoL on average 3.3 years after surgery for PHPT using the 15D in our patient cohort (n=124) and compared the results to those of an age- and gender-standardized general population (n=1099). We studied self-reported blood pressure and current medications; new comorbidities were retrieved from electronic patient records. A total of 104 (83%) patients [eight with serum calcium (1.34-1.46 mmol/l)] returned the questionnaires. After a follow-up of 3.3 years (range 23 to 55 months), systolic and diastolic blood pressure had decreased significantly compared to baseline (the situation before surgery, p<0.001). Thirty-four (33%) had acquired a new diagnosis (range 1-7), the most common being cardiovascular disease and cancer. Mean 15D score was significantly better compared to baseline (p<0.001), the dimensions of sleeping, mental function, discomfort and symptoms, and depression had further improved (p<0.01), and no longer differed from that of the general population. In PHPT, after >2 years follow-up, surgery improves blood pressure and restores neurocognitive function and sleep to the level of the general population. The improvements observed in overall HRQoL at one year after surgery are sustained, but overall HRQoL does not reach that of the general population.
原发性甲状旁腺功能亢进症（PHPT）手术可改善健康相关生活质量（HRQoL），但中期（>2年）随访后效果是否持续，以及HRQoL某些或所有维度的结果是否能达到普通人群水平尚不清楚。我们使用15D量表对我们患者队列（n = 124）中接受PHPT手术后平均3.3年的HRQoL进行了随访，并将结果与年龄和性别标准化的普通人群（n = 1099）进行了比较。我们研究了自我报告的血压和当前用药情况；从电子病历中获取新的合并症信息。共有104名（83%）患者[8名血清钙水平为（1.34 - 1.46 mmol/l）]返回了问卷。在3.3年（范围23至55个月）的随访后，收缩压和舒张压与基线（手术前情况，p<0.001）相比显著降低。34名（33%）患者有了新的诊断（范围1至7种），最常见的是心血管疾病和癌症。与基线相比，平均15D评分显著更好（p<0.001），睡眠、心理功能、不适与症状以及抑郁维度进一步改善（p<0.01），且与普通人群无差异。在PHPT中，>2年随访后，手术可改善血压，并使神经认知功能和睡眠恢复到普通人群水平。手术后1年观察到的总体HRQoL改善得以持续，但总体HRQoL未达到普通人群水平。
