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[Polymorphonuclear leukocyte elastase (PMNE) levels in surgical patients with postoperative infections]
Abstract:
To study the role of lysozomal enzyme released from polymorphonuclear leukocytes during postoperative infections, plasma levels of PMNE were measured serially in 53 patients who underwent digestive surgery. The patients were divided into two groups, 18 patients with postoperative infections (infected group), and 35 patients without infections (non-infected group). The PMNE levels in the non-infected group elevated during one week with peak value in one postoperative day, but returned to preoperative levels in two weeks. The levels of fibronectin (FN), C3, C4 and antithrombin III (ATIII) were decreased after surgery, but returned within seven postoperative days. On the contrary, the PMNE levels in the infected group remained high two weeks after operations and elevated higher than those of non-infected group before clinical signs of infections. In infected group, the levels of FN and ATIII were significantly decreased two weeks after surgery, compared to those of non-infected group. Correlations were demonstrated between the amount of PMNE and the decrease in the levels of FN and ATIII. It is suggested PMNE might play a role in the pathobiochemical alterations including of acceleration of coagulation during postoperative infections. The measurement of the levels of PMNE in the postoperative course seems to be an useful index to early diagnosis of postoperative infections.
Insights
Elevated levels of polymorphonuclear neutrophil elastase (PMNE) in patients after digestive surgery can indicate early postoperative infections. High PMNE correlates with decreased fibronectin and antithrombin III, suggesting a role in infection-related coagulation changes.
Area of Science:
- Biochemistry
- Immunology
- Surgical Pathology
Background:
- Postoperative infections pose significant risks following digestive surgery.
- Polymorphonuclear leukocytes (PMNs) are key immune cells involved in infection response.
- Lysozomal enzymes released by PMNs may contribute to pathological processes.
Purpose of the Study:
- To investigate the role of PMNE in postoperative infections.
- To assess plasma PMNE levels as an early diagnostic marker for infection.
- To explore the relationship between PMNE and other biochemical markers.
Main Methods:
- Serial measurement of plasma PMNE levels in 53 patients undergoing digestive surgery.
- Categorization of patients into infected (n=18) and non-infected (n=35) groups.
- Monitoring of fibronectin (FN), C3, C4, and antithrombin III (ATIII) levels.
Main Results:
- PMNE levels peaked early in non-infected patients but remained elevated for two weeks in infected patients.
- Infected patients showed significantly lower FN and ATIII levels at two weeks post-surgery.
- Elevated PMNE levels preceded clinical signs of infection and correlated with decreased FN and ATIII.
Conclusions:
- PMNE may contribute to pathobiochemical alterations, including accelerated coagulation, during postoperative infections.
- Plasma PMNE levels serve as a useful index for the early diagnosis of postoperative infections.
- Further research into PMNE's role in infection-induced coagulopathy is warranted.