甲状旁腺切除对尿毒症继发性甲状旁腺功能亢进症患者生存质量的影响  

Effects of parathyroidectomy on quality of life in uremic patients with secondary hyperparathyroidism

作　　者：伦立德[1] 刘东[1] 高卓[1] 李新伦[1] 魏学明[1] 胡瑞海[1] 缪静[1] 

机构地区：[1]空军总医院肾内科,北京100142

出　　处：《中国血液净化》2014年第1期23-26,共4页Chinese Journal of Blood Purification

基　　金：北京首都临床特色应用研究基金(Z111107058811085)资助

摘　　要：目的观察甲状旁腺切除对尿毒症继发性甲状旁腺功能亢进症(secondary hyperparathyroidism,SHPT)患者生存质量的影响。方法选取30例尿毒症继发性甲状旁腺功能亢进患者,手术切除甲状旁腺,于手术前及手术1年后测定血钙、血磷、全段甲状旁腺激素(iPTH)水平,计算钙磷乘积,采用肾脏病生存质量KDQOL-SFTM量表评价生存质量。结果与手术前比较,甲状旁腺切除1年后患者血iPTH、血磷、钙磷乘积、血钙水平均明显下降(t=-9.563、-5.994、-7.197、-4.928,均P=0.000);SF-36总分(61.3±19.比51.2±24.5,t=2.456,P=0.021)、躯体健康(PF,56.5±27.0比51.8±32.1,P<0.05)、躯体角色功能(RP,48.2±41.9比28.5±40.1,P<0.05)、躯体疼痛(BP,66.1±26.7比53.6±27.9,P<0.05)、总体健康(GH,50.4±22.1比40.6±23.6,P<0.05)评分均明显提高;肾病相关生存质量总体健康评估(OHR,73.8±11.1比65.8±15.2,t=2.699,P=0.012)、症状与不适(SP,85.8±10.5比73.8±11.1,P<0.05)、肾病对生活的影响(EKD,77.1±16.6比65.3±20.7,P<0.01)、睡眠(Sleep,75.1±23.0比58.9±24.5,P<0.01)评分均明显增加。结论甲状旁腺切除能有效改善尿毒症严重继发性甲状旁腺功能亢进患者的生活质量。Objective To observe the effect of parathyroidectomy on quality of life in uremic patients with secondary hyperparathyroidism.Methods Parathyroidectomy was performed for 30 uremic patients on hemodialysis with secondary hyperparathyroidism.Serum calcium （Ca）,phosphorus （P）,calcium and phosphorus product （Ca×P）,and intact parathyroid hormone （iPTH） were measured before and one year after parathyroidectomy.The Kidney Disease Quality of Life Short Form-36 （KDQOL SF-36） questionnaire was used to evaluate quality of life before and one year after parathyroidectomy.Results Serum iPTH,calcium,phosphorus and Ca×P were significantly lower after parathyroidectomy for one year than the values before the surgery （tiPTH=-9.563,P=0.000; tCa=-4.928,P=0.000; tp=-5.994,P=0.000; tCa × p=-7.197,P=0.000）.SF-36 （61.3±19.6 vs.51.2±24.5,t=2.456,P=0.021）,and overall health rating （73.8±11.1 vs.65.8±15.2,t=2.699,P=0.012） were increased after parathyroidectomy for one year.Physically associated problems were also improved significantly,including physical function （56.5±27.0 vs.51.8±32.1,P＜0.05）,role-physical function （48.2±41.9 vs.28.5±40.1,P＜0.05）,bodily pain （66.1±26.7 vs.53.6±27.9,P＜0.05）,general health （50.4±22.1 vs.40.6±23.6,P＜0.05）,symptoms/problems （85.8±10.5 vs.73.8±11.1,P＜0.05）,effects of kidney disease （77.1±16.6 vs.65.3±20.7,P＜0.01） and sleep （75.1±23.0 vs.58.9±24.5,P＜0.01）.Conclusion Parathyroidectomy effectively improves quality of life in hemodialysis patients with secondary hyperparathyroidism.

关 键 词：尿毒症 继发性甲状旁腺功能亢进症 甲状旁腺切除术 生存质量 

分 类 号：R318.16[医药卫生—生物医学工程]