全甲状腺切除术后的甲状腺功能低下和死亡率:全国匹配的队列研究
Rasmus Reinke1, Sebastian Udholm1, Christian Fynbo Christiansen2
1Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus University Hospital, Aarhus, Denmark.
Clinical endocrinology
|February 20, 2024
概括
完全甲状腺切除术后的甲状腺功能低下会增加死亡风险,但只有当手术是针对恶性瘤时. 良性疾病,如喉或甲状腺毒性病,并没有显示出低副甲状腺症的死亡风险增加.
科学领域:
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
- 公共卫生 公共卫生
背景情况:
- 全甲状腺切除术 (TT) 是一种常见的手术,具有已知的低副甲状腺症 (hypoPT) 风险.
- 最近的研究表明, hypoPT 与死亡率增加之间存在联系.
- 评估TT后低PT的长期后果对于患者管理至关重要.
研究的目的:
- 为了确定两十年来在丹麦大量人口中TT后的hypoPT的频率.
- 评估hypoPT和TT后的整体死亡率之间的关联.
- 调查TT的适应性是否影响hypoPT.患者的死亡风险.
主要方法:
- 从1998年至2017年使用丹麦国家登记处进行的回顾性队列研究.
- 确定了接受TT的7912名患者和匹配的比较队列.
- 通过活性维生素D治疗>12个月术后定义的hypoPT;使用Cox回归分析的死亡率.
主要成果:
- 在TT后12个月的hypoPT患病率为16.6%.
- 患有hypoPT的患者具有显著增加的全因死亡风险 (HR 1.34).
- 亚组分析显示,死亡率仅在恶性瘤病例中增加 (HR 2.48),而不是良性迹象 (,甲状腺毒性).
结论:
- 甲状腺功能低下症是全甲状腺切除术后的一个普遍并发症.
- 与hypoPT相关的死亡风险增加主要在TT用于恶性瘤时观察到.
- 对于良性甲状腺疾病,TT后的hypoPT似乎不会增加死亡风险.
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