Significance of fluctuated level of endogenous bactericidal/permeability-increasing protein in patients after major abdominal surgery / 解放军医学杂志

ABSTRACT

Objective To investigate the fluctuated pattern of endogenous bactericidal/permeability-increasing protein(BPI)levels,and to elucidate its significance in endotoxin response after major abdominal surgery.Methods Eleven patients undergoing major abdominal surgery were involved in present study.The levels of plasma BPI,lipopolysaccharide-binding protein(LBP)and interleukin-6(IL-6)were measured preoperatively and on postoperative days 1,3,5,7,and 14 by ELISA.Plasma endotoxin concentration was determined with the chromogenic limulus amebocyte lysate(LAL),which was modified by perchloric acid(PCA)pretreatment of samples.The polymorphonuclear neutrophil count was also done at each time point.Results In comparison with normal controls,plasma BPI/LBP ratios [(1.058?0.074)?10-3,P=0.004] were significantly increased on postoperative day 1,maintained at same level on day 3,and declined on day 5.No plasma IL-6 was detected from the blood of all the 11 patients prior to operation,but plasma IL-6 level rose rapidly on day 1 after operation(27.440?12.144pg/ml,P=0.04),maintaining a high level(11.530?5.312pg/ml)on postoperative day 3,and disappeared on day 5.Conclusions Plasma BPI/LBP ratios were markedly elevated during 3 days after a major abdominal surgery,and endogenous elevated BPI may play an important role in prevention from the development of endotoxemia in surgical patients.