Nikitina T P, Gladkova I N, Rusakov V F, Chernikov R A, Karelina Yu V, Efremov S M, Ionova T I
Saint Petersburg State University Hospital.
Probl Endokrinol (Mosk). 2022 Jan 11;68(1):27-39. doi: 10.14341/probl12825.
For a comprehensive assessment of the effect of surgery in patients with primary hyperparathyroidism (PHPT), as well as for monitoring the condition of patients after treatment, it sounds reasonable to evaluate quality of life (QoL) and symptoms in PHPT patients before and after surgery.
The aim of this study was to assess changes in the QoL and symptoms in patients with PHPT after surgery.
During prospective observational study, patients filled out QoL questionnaires and evaluated the presence and severity of their symptoms prior to parathyroidectomy (PTE) and 3, 12 months after surgery. Statistical analysis included the following methods: Student's t-test or Wilcoxon's non-parametric test, the generalized estimating equations (GEE), correlation analysis, χ2 and McNemar tests.
The study included 72 patients (mean age 52 years, 97.2% female) with symptomatic (68.1%) and asymptomatic (31.9%) PHPT. Before surgery patients with PHPT exhibited significantly decreased role functioning, physical and social well-being, and vitality. Half of PHPT patients experienced moderate-to-severe symptoms such as weakness, fatigue, loss of concentration, mood changes, as well as joint and bone pain; the association between symptoms experienced and the extent of QoL impairment before surgery was shown. Three months after PTE improvement in both physical and psychological components of QoL was shown. Positive QoL changes were demonstrated in patients with both symptomatic and asymptomatic PHPT and they preserved for 12 months after surgery. Also within 12 months after PTE significant decrease in PHPT-associated symptoms such as weakness, fatigue, loss of concentration and mood changes was found.
The results obtained demonstrate efficacy of PTE from the patient's perspective and confirm the value of QoL assessment in PHPT patients in management of this patients' population both for decision making and for evaluation of benefits of surgery and the degree of recovery of patients at long term follow-up.
为全面评估手术对原发性甲状旁腺功能亢进症（PHPT）患者的疗效，并监测治疗后患者的状况，在手术前后评估PHPT患者的生活质量（QoL）和症状似乎是合理的。
本研究旨在评估PHPT患者术后QoL和症状的变化。
在一项前瞻性观察研究中，患者在甲状旁腺切除术（PTE）前、术后3个月和12个月填写QoL问卷并评估其症状的存在情况和严重程度。统计分析包括以下方法：学生t检验或威尔科克森非参数检验、广义估计方程（GEE）、相关分析、χ²检验和麦克尼马尔检验。
该研究纳入了72例患者（平均年龄52岁，97.2%为女性），其中有症状的PHPT患者占68.1%，无症状的占31.9%。术前，PHPT患者的角色功能、身体和社会幸福感以及活力显著下降。一半的PHPT患者经历了中度至重度症状，如虚弱、疲劳、注意力不集中、情绪变化以及关节和骨痛；术前症状与QoL受损程度之间的关联得到了体现。PTE术后3个月，QoL的身体和心理成分均有改善。有症状和无症状的PHPT患者均出现了QoL的积极变化，且术后12个月仍保持。此外，在PTE术后12个月内，发现与PHPT相关的症状如虚弱、疲劳、注意力不集中和情绪变化显著减少。
从患者角度来看，所得结果证明了PTE的疗效，并证实了QoL评估在PHPT患者管理中的价值，无论是用于决策，还是评估手术益处以及长期随访中患者的恢复程度。
