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接受脊柱减压与稳定手术的脊柱骨关节炎患者术后血液学、生化及氧化还原状态参数的变化

Postoperative Changes in Hematological, Biochemical, and Redox Status Parameters in Spinal Osteoarthritis Patients Undergoing Spinal Decompression and Stabilization Surgery.

作者信息

Mirković Milan, Kotur-Stevuljević Jelena, Vekić Jelena, Bogavac-Stanojević Nataša, Milić Anđelka, Mirković Sanja, Vujović Ankica, Rakić Marija, Lunić Tanja, Baščarević Zoran, Božić Nedeljković Biljana

机构信息

Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.

Institute for Orthopedic Surgery "Banjica", 11000 Belgrade, Serbia.

出版信息

J Clin Med. 2025 Sep 6;14(17):6306. doi: 10.3390/jcm14176306.

Abstract

Spinal osteoarthritis (sOA) is a degenerative condition marked by pain, inflammation, and restricted mobility. While surgical interventions such as spinal decompression and stabilization are common, their impact on redox status and inflammatory markers remains underexplored. This study aimed to assess the effects of surgery on clinical, hematological, biochemical, and redox parameters in patients with sOA. A total of 25 patients diagnosed with sOA underwent spinal decompression and stabilization surgery. Preoperative and postoperative assessments included hematological and biochemical analyses, redox status evaluation (TAS, TOS, GSH, AOPP, SOD), and inflammatory markers such as IL-6. Disease severity was graded using the Kellgren-Lawrence (K-L) system. Postoperatively, there was a significant decrease in neutrophil count ( = 0.014) and AOPP levels ( < 0.001), with a corresponding increase in lymphocyte count ( = 0.016), erythrocyte count ( = 0.036), and IL-6 levels ( = 0.008). TAS levels decreased ( = 0.006), while enzymatic antioxidants, such as SOD increased ( = 0.031). Erythrocyte GSH remained low, with a non-significant postoperative decrease. Patients with higher K-L grades exhibited greater redox imbalance, with reduced preoperative GSH and elevated postoperative superoxide anion, TOS, and SOD levels. More severe cases also showed decreased postoperative erythrocyte, hemoglobin, and PTH levels, and increased TAS and AOPP levels. Factorial analysis highlighted clusters associated with oxidative stress, inflammation, and clinical performance. The results underscore the complex relationship between inflammation, oxidative stress, and recovery in sOA. These findings suggest the importance of targeted postoperative strategies to support redox homeostasis and modulate inflammation in sOA patients.

摘要

脊柱骨关节炎(sOA)是一种以疼痛、炎症和活动受限为特征的退行性疾病。虽然诸如脊柱减压和固定等手术干预很常见,但它们对氧化还原状态和炎症标志物的影响仍未得到充分研究。本研究旨在评估手术对sOA患者临床、血液学、生化和氧化还原参数的影响。共有25例被诊断为sOA的患者接受了脊柱减压和固定手术。术前和术后评估包括血液学和生化分析、氧化还原状态评估(总抗氧化能力、总氧化能力、谷胱甘肽、晚期氧化蛋白产物、超氧化物歧化酶)以及诸如白细胞介素-6等炎症标志物。使用凯尔格伦-劳伦斯(K-L)系统对疾病严重程度进行分级。术后,中性粒细胞计数(P = 0.014)和晚期氧化蛋白产物水平(P < 0.001)显著降低,淋巴细胞计数(P = 0.016)、红细胞计数(P = 0.036)和白细胞介素-6水平(P = 0.008)相应增加。总抗氧化能力水平降低(P = 0.006),而超氧化物歧化酶等酶促抗氧化剂增加(P = 0.031)。红细胞谷胱甘肽水平仍然较低,术后有不显著的降低。K-L分级较高的患者表现出更大的氧化还原失衡,术前谷胱甘肽降低,术后超氧阴离子、总氧化能力和超氧化物歧化酶水平升高。更严重的病例术后还表现出红细胞、血红蛋白和甲状旁腺激素水平降低,以及总抗氧化能力和晚期氧化蛋白产物水平升高。因子分析突出了与氧化应激、炎症和临床表现相关的聚类。结果强调了sOA中炎症、氧化应激和恢复之间的复杂关系。这些发现表明,针对性的术后策略对于支持sOA患者的氧化还原稳态和调节炎症具有重要意义。

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