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继发性甲状旁腺功能亢进患者术后血清钙、磷、iPTH、CRP、IL-6和TNF-p水平的变化

Postoperative serum changes in calcium, phosphorus, iPTH, CRP, IL-6, and TNF-p levels in patients with secondary hyperparathyroidism.

作者信息

Feng Wenjing, Xu Runtao, Mu Jinghui, Jie Li, Cheng Mingjing

机构信息

Third Hospital of Hebei Medical University, General Surgery, Shijiazhuang City, Hebei Province, China.

出版信息

J Med Biochem. 2025 Aug 21;44(5):1083-1092. doi: 10.5937/jomb0-55372.

Abstract

BACKGROUND

This study investigates the impact of food structure intervention based on the fast-track surgery (FTS) concept on the postoperative nutritional status, immune response, and recovery outcomes of patients with secondary hyperparathyroidism (SHPT). Specifically, it explores changes in serum calcium and phosphorus levels, immune-reactive parathyroid hormone (iPTH), inflammatory markers (CRf) IL-6, TNF-P), and rehabilitation outcomes following surgical intervention.

METHODS

Fifty SHPT patients who underwent surgery at the Third Hospital of Hebei Medical University were randomly divided into two groups: a control group (CG) receiving conventional nursing care and an observation group (OG) receiving food structure intervention based on the FTS concept. Preand postoperative comparisons were made for nutritional indicators (hemoglobin, albumin), biochemical markers (calcium, phosphorus, calcium-phosphorus product, iPTH), inflammatory markers (CRF) IL-6, TNF-P), pain levels (Visual Analog Scale), muscle strength (MRC scale), and postoperative complications.

RESULTS

The OG showed significantly improved nutritional status, with higher hemoglobin and albumin levels compared to the CG. Additionally, blood calcium levels and calcium-phosphorus product were significantly elevated, while blood phosphorus and iPTH levels were reduced in the OG. Inflammatory markers (CRf) IL-6, TNF-P) were significantly lower in the OG. Pain scores (VAS) were lower, muscle strength (MRC) was higher, and the incidence of complications was significantly reduced in the OG compared to the CG.

CONCLUSIONS

Food structure intervention based on the FTS concept enhances nutritional status, improves mineral metabolism, reduces postoperative inflammation, and accelerates recovery in SHPT patients. This study supports the implementation of FTS principles in perioperative care to improve outcomes and reduce complications for SHPT patients, offering valuable insights for optimising clinical management and nursing practices in this patient population.

摘要

背景

本研究探讨基于快速康复外科(FTS)理念的食物结构干预对继发性甲状旁腺功能亢进症(SHPT)患者术后营养状况、免疫反应及康复结局的影响。具体而言,研究手术干预后血清钙、磷水平、免疫反应性甲状旁腺激素(iPTH)、炎症标志物(CRf、IL-6、TNF-P)的变化以及康复结局。

方法

选取在河北医科大学第三医院接受手术的50例SHPT患者,随机分为两组:对照组(CG)接受常规护理,观察组(OG)接受基于FTS理念的食物结构干预。比较两组术前及术后的营养指标(血红蛋白、白蛋白)、生化指标(钙、磷、钙磷乘积、iPTH)、炎症标志物(CRF、IL-6、TNF-P)、疼痛程度(视觉模拟评分法)、肌肉力量(医学研究委员会肌力评分标准)及术后并发症。

结果

观察组营养状况显著改善,血红蛋白和白蛋白水平高于对照组。此外,观察组血钙水平及钙磷乘积显著升高,血磷和iPTH水平降低。观察组炎症标志物(CRf、IL-6、TNF-P)显著降低。与对照组相比,观察组疼痛评分(VAS)更低,肌肉力量(MRC)更高,并发症发生率显著降低。

结论

基于FTS理念的食物结构干预可改善SHPT患者的营养状况,促进矿物质代谢,减轻术后炎症反应,加速康复。本研究支持在围手术期护理中实施FTS原则以改善SHPT患者的结局并减少并发症,为优化该患者群体的临床管理和护理实践提供了有价值的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec5d/12433303/36aedd903364/jomb-44-5-2505083F_g001.jpg

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