[Polymorphonuclear leukocyte elastase (PMNE) levels in surgical patients with postoperative infections].
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.
Matsui
N
N
First Department of Surgery, Yamaguchi University, Ube, Japan.
Morita
N
N
Noshima
S
S
Enoki
T
T
Aikawa
F
F
Kobayashi
T
T
Esato
K
K
D000368:Aged; D000990:Antithrombin III / Q000032:analysis; D005353:Fibronectins / Q000097:blood; D006801:Humans; D007239:Infections / Q000201:enzymology*; D019272:Leukocyte Elastase; D008875:Middle Aged; D009504:Neutrophils / Q000201:enzymology*; D010196:Pancreatic Elastase / Q000097:blood* / Q000502:physiology; D011183:Postoperative Complications / Q000201:enzymology*
D005353:Fibronectins; D000990:Antithrombin III; D010196:Pancreatic Elastase; D019272:Leukocyte Elastase