Paratiroid Allotransplantasyonu Başarısında Psikolojik Stresin Boyutları

Abstract

Paratiroit oto/allotransplantasyonu (PA), paratiroit hücrelerinden paratiroit hormonunun (PTH) düşük seviyelerde salgılanmasıyla gelişen nadir kalıcı bir durum olan hipoparatiroidizm tedavisinde önemli bir alternatif yöntem olabilme potansiyeline sahiptir. Bu çalışmada biz PA uygulanan hastaların PTH düzeyleri ile psikolojik stres durumları arasındaki olası ilişki araştırmayı amaçladık. Kalıcı hipoparatiroidizmli üç hasta paratiroit allotransplantasyonu öncesi ve sonrası üç aylık süreçte takip edildi. Bu hastaların muayeneleri biyokimyasal parametreler (iPTH, Ca, ve P) ile değerlendirildi. Hastaların stres ve anksiyete düzeyleri ise Durum-Sürekli Anksiyete Ölçeği (STAİ) ve Algılanan Stress Ölçeği (PSS) gibi psikolojik testlerle belirlendi. Tüm hastaların PA sonrasında iPTH seviyelerinde belirli oranlarda artış gözlendi. Hastalar arasında düşük anksiyete ve stres düzeyine sahip hasta 2’nin, PA sonrası PTH seviyeleri fizyolojik olarak normal kabul edilen değerlere ulaştı. Ayrıca hastaların PA 1. ay sonrası serum iPTH düzeyindeki iyileşme ile PSS skoru arasında negatif bir korelasyonun olduğu tespit edildi (r =-0.999, p = 0.028). Bu raporun sonuçları ilk kez paratiroit allotransplantasyonu sonrası PTH salınımının artarak normal seviyelere ulaşamamasının nedenlerinden birinin hastaların stres düzeyi olabileceğini göstermiştir. Sonuç olarak, bu çalışma, PTH’nın bir stres biyobelirteci olabileceğini düşündürmektedir.

Keywords

• Paratiroit Allotransplantasyon
• Paratiroid hormon
• Psikolojik stres
• STAİ
• PSS

Aspects of Psychological Stress in Success of Parathyroid Allotransplantation

Abstract

Parathyroid auto/allotransplant (PA) may be a valuable alternative in the treatment of permanent hypoparathyroidism which is defined by insufficient levels of parathyroid hormone (PTH). Here, we aimed to investigate a possible association between the PTH levels of the patients who had undergone PA and their psychological stress conditions. The three patients with hypoparathyroidism were reported before and after PA for three-month-follow-up period. The examinations of patients were assessed by biochemical parameters [intact PTH (iPTH), Ca, and P]. The anxiety and stress levels of patients were assessed by self-report measures: State-Trait Anxiety Inventory (STAI-S/T) and Perceived Stress Scale (PSS). Although iPTH levels of all patients had a tendency to increase after PA, one of the patients with a low level of anxiety and stress only reached the normal range of PTH levels. The recovery of the serum iPTH levels at month 1 post-PA was negatively correlated with PSS scores of patients (r =-0.999, p=0.028). The outcomes of this report showed for the first time that insufficient PTH release, even after PA, might be related to the stress level of patients. By taking all results into consideration, PTH could be speculated as a stress biomarker

Keywords

• Parathyroid allotransplantation
• parathyroid hormone
• psychological stress
• STAI
• PSS

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