甲状旁腺激素及VitD3在口腔颌面外科围术期的变化及影响因素

doi:10.19438/j.cjoms.2017.05.010

中国口腔颌面外科杂志 ›› 2017, Vol. 15 ›› Issue (5): 427-430.doi: 10.19438/j.cjoms.2017.05.010

甲状旁腺激素及VitD3在口腔颌面外科围术期的变化及影响因素

王秋旭¹，王瑶²，肖博洋¹，刘维贤¹

1.中国医科大学附属盛京医院口腔颌面外科，辽宁沈阳 110004;
2.沈阳农业大学，辽宁沈阳 110004

收稿日期:2017-01-09 出版日期:2017-08-30 发布日期:2017-10-27
通讯作者: 刘维贤，E-mail:liuwx@sj-hospital.org
作者简介:王秋旭（1971-），男，博士，副教授，E-mail：wangqx@sj-hospital.org
基金资助:
辽宁省科学技术项目（2011020215-404）

Parathyroid hormone and vitamin D3 changes perioperative period of oral and maxillofacial surgery

WANG Qiu-xu¹, WANG Yao², XIAO Bo-yang¹, LIU Wei-xian¹.

1.Department of Oral and Maxillofacial Surgery, Shengjing Hospital, China Medical University. Shenyang 110004;
2.Shenyang Agricultural University. Shenyang 110004, Liaoning Province, China

Received:2017-01-09 Online:2017-08-30 Published:2017-10-27

摘要/Abstract

摘要： 目的：观察口腔颌面外科围术期患者血清中甲状旁腺激素（parathyroid hormone，PTH）、钙、磷、维生素D3(vitamin D3，VitD3)及其受体（VDR）的浓度变化，分析影响其浓度变化的因素。方法：选取2013年7月—2014年2月中国医科大学附属盛京医院口腔颌面外科住院患者116例，于入院第2天及术后第1天清晨，空腹抽取静脉血各2 mL，应用酶联免疫法（ELISA）测定血清VitD3及VDR浓度，Ca²⁺、P3-、PTH浓度通过统计临床资料获得。采用SAS9.2软件包对实验数据进行独立样本t检验及Spearman相关性分析。结果：术后患者PTH值显著增高，PTH指标的变化差异在不同性别间及不同病种间均有统计学意义。术后患者Ca²⁺、VitD3、VDR值显著降低（P<0.05）。手术时间越长，术后PTH值升高越明显，Ca²⁺值降低越明显；出血量越大，术后PTH值升高越明显，Ca²⁺值降低越明显，VDR降低越明显。不同性别间，只有PTH指标变化差异有显著性（P=0.0168），其余指标变化无显著差异。血清P3-指标变化与手术时间及出血量无相关性。结论：口腔颌面外科围术期患者体内PTH、VitD3、Ca²⁺浓度变化与性别、病种、手术时间及术中出血量等因素相关。

关键词: PTH, 钙, 磷, 维生素D3, 口腔颌面外科

Abstract: PURPOSE: To observe the changes of serum parathyroid hormone (PTH), calcium, phosphate, and vitamin D3 (VitD3) and its receptor (VDR) during perioperative period of oral and maxillofacial surgery and the relationship between these changes and gender, age, operation time, and bleeding. METHODS: From July 2013 to February 2014, we recruited 116 hospitalized patients undergoing oral and maxillofacial surgeries in Shengjing Hospital of China Medical University, from whom 2 mL of fasting venous blood were collected on the second day of admission and the first morning after surgery. Patients' serum VitD3 and VDR concentrations were determined by ELISA; concentrations of Ca²⁺, P3-, and PTH were obtained from clinical data. SAS 9.2 software package was used for independent samples t test and Spearman correlation analysis. RESULTS: PTH value was significantly increased after surgery, and the difference of PTH index between patients with different gender and different diseases were statistically significant. Ca²⁺, VitD3, and VDR values were significantly decreased postoperatively. The longer the surgery time, the higher the PTH value; the lower the Ca²⁺ value, the more bleeding, the higher the PTH value, the lower the Ca²⁺ value and the more significant was the VDR decrease. There was no significant difference in the change of PTH index between different genders. There was no correlation between the change of serum phosphate and surgery time or blood loss. CONCLUSIONS: The changes in PTH, VitD3, and Ca²⁺ concentrations in patients undergoing oral and maxillofacial surgery were related to gender, disease, length of surgery, and amount of intraoperative blood loss.

Key words: Parathyroid hormone, Ca²⁺, P^3-, Vitamin D3, Oral and maxillofacial surgery

中图分类号:

R782.05

王秋旭，王瑶，肖博洋，刘维贤. 甲状旁腺激素及VitD3在口腔颌面外科围术期的变化及影响因素[J]. 中国口腔颌面外科杂志, 2017, 15(5): 427-430.

WANG Qiu-xu, WANG Yao, XIAO Bo-yang, LIU Wei-xian.. Parathyroid hormone and vitamin D3 changes perioperative period of oral and maxillofacial surgery[J]. China J Oral Maxillofac Surg, 2017, 15(5): 427-430.

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甲状旁腺激素及VitD3在口腔颌面外科围术期的变化及影响因素

Parathyroid hormone and vitamin D3 changes perioperative period of oral and maxillofacial surgery

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