副甲状腺切除术和新型抑郁症的发展在成年人中,主要的副甲状腺功能障碍症
Lia D Delaney1,2, Adam Furst1, Heather Day1
1Stanford-Surgery Policy Improvement Research and Education Center (S-SPIRE), Department of Surgery, Stanford University School of Medicine, Palo Alto, California.
JAMA surgery
|September 4, 2024
概括
早期副甲状腺切除术对患有原发性副甲状腺症 (PHPT) 的成年人新型抑郁症的发展没有影响. 这一发现对于关于PHPT患者手术风险和益处的知情讨论至关重要.
科学领域:
- 内分泌学 在内分泌学.
- 神经外科 神经外科
- 精神病学是一个精神病学.
背景情况:
- 原发性偏甲状腺症 (PHPT) 与神经精神问题有关.
- 副甲状腺切除术可以改善现有的抑郁症,但其对新发抑郁症的影响尚不清楚.
研究的目的:
- 研究早期甲状腺切除术对患有PHPT的成年人新型抑郁症发生率的影响.
- 为了比较PHPT的手术干预与非手术管理,与新的抑郁症发展有关.
主要方法:
- 利用了国家退伍军人事务数据 (2000-2019) 与目标试验模拟.
- 在早期副甲状腺切除术和非手术管理组中比较新的抑郁率.
- 雇员扩展的考克斯模型与反向概率审查权重,对共变量进行调整.
主要成果:
- 确定了40,231名患有PHPT的成年人,没有以前的抑郁病史.
- 在早期副甲状腺切除术和非手术治疗之间,调整后的新抑郁率没有显著差异 (HR,1.05;95% CI,0.94-1.17).
- 根据年龄和血清水平的子组分析也显示没有影响.
结论:
- 早期甲状腺切除术不会改变PHPT成年人的新型抑郁症发生率.
- 结果对于术前咨询至关重要,以了解甲状腺切除术的好处和风险.
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