Procena uticaja paratiroidektomije na kvalitet života pacijenata sa primarnim asimptomatskim hiperparatiroidizmom
The impact of parathyroidectomy on the quality of life of patients with primary asymptomatic hyperparathyroidism
Докторанд
Jovanović, MilanМентор
Paunović, IvanЧланови комисије
Šipetić-Grujičić, SandraŽivaljević, Vladan
Kisić-Tepavčević, Darija
Durutović, Otaš
Метаподаци
Приказ свих података о дисертацијиСажетак
Uvod
Primarni hiperparatiroidizam (pHPT) predstavlja endokrinološki poremećaj metabolizma
kalcijuma, sa hiperkalcemijom i povišenim ili neadekvatno normalnim koncentracijama
paratiroidnog hormona (PTH). Najčešći je uzrok hiperkalcemije u opštoj populaciji. Jedini
trajni način lečenja je operativni. Pored tipičnih kliničkih simptoma, pHPT je povezan i sa
narušenim kvalitetom života i kognitivnim statusom.
Iz tog razloga je cilj ove studije da ispita da li postoji razlika u kvalitetu života i kognitivnim
funkcijama kod osoba sa asimptomatskim primarnim hiperparatiroidizmom pre i posle
paratiroidektomije. Kao drugi cilj ove studije je identifikacija nezavisnih faktora koji utiču na
kvalitet života i kognitivne funkcije osoba sa asimptomatskim primarnim
hiperparatiroidizmom.
Materijal i metode
Sprovedena je panel studija u Centru za endokrinu hirurgiju Klinike za endokrinologiju,
dijabetes i bolesti metabolizma Kliničkog centra Srbije (CEH KCS) u periodu od 2014. do
2017. godine. Studijom ...su obuhvaćeni pacijenti sa novootkrivenim primarnim
hiperparatiroidizmom kojima je indikovana paratiroidektomija. Kriterijumi za uključivanje u
studiju su dijagnoza asimptomatskog pHPT, stariji od 18 godina, bez prethodne operacije na
paratiroidnim žlezdama, nivo serumskog kalcijuma preko 2,65 mmol/L i PTH preko 65
pg/mL. Kriterijumi za isključivanje su simptomatske forme pHPT, sekundarne forma HPT,
ostali uzroci hiperkalcemije. Prikupljeni su osnovni demografski i klinički podaci o bolesti.
Procena kvaliteta života i neurokognitivnog statusa sprovedena je putem intervjua pre
operacije, kao i posle prvog i šestog meseca od operacije...
NTRODUCTION
Primary hyperparathyroidism (pHPT) represents an endocrine disorder of calcium
metabolism, which presents with hypercalcemia and elevated or inappropriately normal
concentrations of parathyroid hormone (PTH). PHPT is the most common cause of
hypercalcemia in the general population, and surgery represents the only permanent treatment
method. Besides typical clinical symptoms, pHPT may also be associated with poor quality of
life and impaired cognitive status. Thus, the primary aim of the present study was to assess
whether there is a difference in the quality of life and cognitive status in patients with an
asymptomatic pHPT before and after parathyroidectomy. The second objective was to
identify independent factors that affect the quality of life and cognitive functions in patients
with asymptomatic pHPT.
MATERIALS AND METHODS
Between 2014 and 2017, a panel study was conducted at the Center for Endocrine Surgery of
the Clinic for Endocrinology, Diabetes, and Metabolic Disea...ses of the Clinical Center of
Serbia. The study included patients with newly diagnosed asymptomatic primary
hyperparathyroidism in whom parathyroidectomy was indicated, older than 18 years, without
previous surgery on the parathyroid glands, with serum calcium level over 2.65 mmol/L and
PTH level over 65 pg/mL. Patients with symptomatic forms of pHPT, secondary forms of
HPT, and other causes of hypercalcemia were excluded from the study. Basic demographic
data of interest and relevant clinical data were collected. Quality of life and neurocognitive
status were assessed in interviews before surgery, one month, and six months following
surgery...