JCEM：PTH治疗可改善甲状旁腺功能减退患者的生活质量

来自甲状旁腺功能减退患者的主诉，经常反映了生活质量（QOL）的下降，然而，描述这些主诉以及甲状旁腺激素（PTH）治疗在改善这些痛苦的潜在作用的数据很少。为了验证PTH（1–84）治疗是否能改善甲状腺旁腺功能减退患者的生活质量，来自美国哥伦比亚大学内科和外科学院的John P Bilezikian博士及其团队进行了一项研究，该研究发现PTH（1–84）治疗甲状旁腺功能减退可改善生理和心理功能。该研究结果在线发表在2013年4月17日的美国《临床内分泌代谢杂志》（The journal of endocrinology & metabolism）上。

该研究中，44例甲状旁腺功能减退患者接受非盲重组PTH（1–84）治疗。PTH（1–84）治疗前和治疗期间，患者完成RAND36项健康调查（一种覆盖8项生理和心理健康领域的健康相关生活质量的测量方法）。

该研究结果表明，在基线水平，在全部的8项领域，甲状旁腺功能减退患者的分值显著低于标准参考范围（T值－1.35至－0.78；所有P均＜0.001）。随着PTH（1–84）治疗，早在1月时总分值即提高，并且在1年内保持增加（400±200至478±230；P=0.001）。伴随着在1月内，3项心理健康指标（活力，社会功能和心理健康）的改善（T值提高分别为－1.3至－0.7，－1.0至－0.6，－0.9至－0.3；所有P均＜0.05），整体心理健康总评分提高（204±110至247±130；P=0.001）。伴随着2项生理健康指标的改善（生理功能和一般健康状况：T值的增加分别为－0.8至－0.4，－1.2至－0.8；两个P值均＜0.01），整体生理健康总评分同样在一月内增加，并在1年内保持增加（196±110至231±130；P=0.003）。

该研究发现，这些数据提示甲状旁腺功能减退与生活质量的下降相关。伴随着生化控制的改善，这些结果提示PTH（1–84）治疗改善甲状旁腺功能减退患者的生理和心理功能。

与甲状旁腺相关的拓展阅读： 

• Am Heart J：高甲状旁腺激素水平增加心血管病事件风险
• BMJ：钙或可预防甲状旁腺功能亢进
• CSN:防治甲状旁腺功能亢进或改善肾移植预后
• HIFU在尿毒症继发性甲状旁腺功能亢进中的治疗
• 甲状旁腺切除术可改善抑郁症及心血管异常 更多信息请点击：有关甲状旁腺更多资讯

The Effect of PTH(1-84) on Quality of Life in Hypoparathyroidism.
Abstract
Context:Complaints from hypoparathyroid patients often reflect a reduction in quality of life (QOL), yet little data exist characterizing these complaints or the potential effects of PTH therapy to ameliorate them.Objective:We tested the hypothesis that PTH(1-84) therapy improves QOL in hypoparathyroidism.Design:Fifty-four hypoparathyroid subjects received open-label rhPTH(1-84). Before and during PTH(1-84), subjects completed the RAND 36-Item Health Survey, a measure of health-related QOL covering 8 domains of physical and mental health.Results:At baseline, subjects scored significantly lower than the normative reference range in all 8 domains (T-scores -1.35 to -0.78; p<0.001 for all). With PTH(1-84), the total score improved as early as month 1 and remained higher through 1 year (400 ± 200 to 478 ± 230; p=0.001). The overall mental component summary score improved (204 ± 110 to 247 ± 130; p=0.001), as did 3 mental health domains (vitality, social functioning, mental health), all within 1 month (T-scores improving from -1.3 to -0.7, -1.0 to -0.6, -0.9 to -0.3, respectively; p<0.05 for all). The overall physical component summary score also increased by 1 month and remained higher at 1 year (196 ± 110 to 231 ± 130; p=0.003) as did 2 physical health domains (physical functioning and general health: T-scores improving from -0.8 to -0.4, -1.2 to -0.8, respectively; p<0.01 for both).Conclusions:These data suggest that hypoparathyroidism is associated with compromised QOL. Along with improved biochemical control, these results indicate that PTH(1-84) treatment of hypoparathyroidism improves physical and mental functioning.