甲状旁腺腺瘤重量与原发性甲状旁腺功能亢进治疗后的死亡风险

Parathyroid adenoma weight and the risk of death after treatment for primary hyperparathyroidism.

作者信息

Hedbäck G, Odén A, Tisell L E

机构信息

Department of Surgery, Göteborg University, Gothenburg, Sweden.

出版信息

Surgery. 1995 Feb;117(2):134-9. doi: 10.1016/s0039-6060(05)80076-5.

DOI:10.1016/s0039-6060(05)80076-5

PMID:7846616

Abstract

BACKGROUND

Patients operated on for primary hyperparathyroidism run an increased risk of death, as was found in a previous long-term follow-up of 896 patients.

METHODS

In the present study the adenoma weight was determined in 713 patients with single parathyroid gland disease operated on between 1956 and 1982 and followed up in 1986. The adenoma weight was investigated for its usefulness as a prognostic factor.

RESULTS

The analysis showed that the adenoma weight was significantly related to the risk of death (p < 0.001). Also a relationship was noted between glandular weight and preoperative serum calcium level (p < 0.001), although the serum calcium level had no predictive value in relation to the risk of death beyond that of the adenoma weight. The risk increase was also estimated as a function of adenoma weight. A moderate adenoma weight increase in a patient with primary hyperparathyroidism was found to imply an increased risk of death, corresponding to the increased risk of smokers as compared with nonsmokers.

CONCLUSIONS

The results of this study support surgical treatment at an early stage of primary hyperparathyroidism.

摘要

背景

如先前对896例患者进行的长期随访所示，接受原发性甲状旁腺功能亢进手术的患者死亡风险增加。

方法

在本研究中，测定了1956年至1982年间接受单发性甲状旁腺疾病手术并于1986年进行随访的713例患者的腺瘤重量。研究腺瘤重量作为预后因素的有用性。

结果

分析表明腺瘤重量与死亡风险显著相关（p < 0.001）。还注意到腺体重量与术前血清钙水平之间存在关系（p < 0.001），尽管血清钙水平相对于死亡风险而言，除了腺瘤重量之外没有预测价值。风险增加也被估计为腺瘤重量的函数。发现原发性甲状旁腺功能亢进患者腺瘤重量适度增加意味着死亡风险增加，这与吸烟者相对于非吸烟者增加的风险相当。