中国血液净化

中国血液净化 ›› 2014, Vol. 13 ›› Issue (01): 23-26.doi: 10.3969/j.issn.1671-4091.2014.1.006

• 临床研究 • 上一篇    下一篇

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

伦立德,刘东,高卓,李新伦,魏学明,胡瑞海,缪静   

  1. 空军总医院肾内科
  • 收稿日期:2013-09-30 修回日期:2013-10-27 出版日期:2014-01-12 发布日期:2014-01-12
  • 通讯作者: 伦立德 lunlideldm@163.com E-mail:lunlideldm@163.com
  • 基金资助:

    本课题为北京首都临床特色应用研究基金(Z111107058811085)资助

Effects of a parathyroidectomy on health-related quality of life in uremic patients with secondary hyperparathyroidism

  • Received:2013-09-30 Revised:2013-10-27 Online:2014-01-12 Published:2014-01-12

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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±19.6 VS 51.2±24.5,t=2.456,P=0.021）、躯体健康(PF,56.5±27.0 VS 51.8±32.1, P<0.05)、躯体角色功能(RP, 48.2±41.9VS 28.5±40.1,P<0.05)、躯体疼痛(BP, 66.1±26.7 VS 53.6±27.9,P<0.05)、总体健康(GH,50.4±22.1VS 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±11.1VS 65.8±15.2, t=2.699,P=0.012）、症状与不适(SP,85.8±10.5 VS 73.8±11.1, P<0.05)、肾病对生活的影响(EKD,77.1 ± 16.6 VS 65.3±20.7,P<0.01)、睡眠(Sleep, 75.1±23.0 VS 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。

关键词: 尿毒症, 继发性甲状旁腺功能亢进, 甲状旁腺切除, 生存质量

Abstract: 【Abstract】Objective To observe the effect of a parathyroidectomy on health-related quality of life in uremic patients with secondary hyperparathyroidism. Methods Thirty uremic patients under hemodialysis therapy receiced a parathyroidectomy for secondary hyperparathyroidism.They were prospectively studied the serum calcium(Ca),phosphorus(P),the product of calcium and phosphorus(Ca×P),parathyroid(iPTH) before and 1 year after parathyroidectomy. Throughout the follow-up period, all subjects completed the Kidney Disease Quality of Life Short Form-36 (KDQOL SF-36) questionnaire at before and 1 year after parathyroidectomy. Results Serum levels of iPTH,calcium,phosphorus and Ca×P were lower at 1 year after treatment compared with that before parathyroidectomy (tiPTH=-9.563,P=0.000,tp=-5.994,P=0.000,tca×p=-7.197,P=0.000,tca= -4.928,P=0.000). SF-36（61.3±19.6 VS 51.2±24.5, t=2.456,P=0.021） and overall health rating(OHR，73.8±11.1VS 65.8±15.2, t=2.699,P=0.012) of our study were increased at one year after parathyroidectomy.There were significant improvement among physically associated problems such as physical function(PF, 56.5±27.0 VS 51.8±32.1,P<0.05)、role-physical(RP, 48.2±41.9 VS 28.5±40.1,P<0.05)、bodily pain(BP, 66.1±26.7 VS 53.6±27.9,P<0.05)、general health(GH, 50.4±22.1 VS 40.6±23.6,P<0.05)、symptom/problems(SP,85.8±10.5VS 73.8±11.1, P<0.05)、effects of kidney disease(EKD,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 could improve health-related quality of life among hemodialysis patients with secondary hyperparathyroidism.

Key words: Uremia, Secondary hyperparathyroidism, Parathyroidectomy, Quality of life