[Changes in serum neopterin levels in patients after trauma].

OBJECTIVE

To evaluate the clinical significance of changes in serum neopterin levels in patients after trauma.

METHODS

41 patients with mechanical injury were divided into three groups according to the injury severity score (ISS). In all patients, blood collection was started within 24 h after injury, and blood samples were obtained at 3, 7, 14, and 21 d post-trauma. The relationship was determined between serum neopterin levels and ISS, multiple organ dysfunction syndrome (MODS) and prognosis in patients.

RESULTS

Patients with ISS > or = 25 showed a high neopterin level compared with those with ISS < 16 (P < 0.05 or P < 0.01), and a correlation between mean neopterin levels and ISS was observed in severely injured patients (r = 0.518, P < 0.05). High neopterin levels were measured in patients who developed MODS, showing a persistent marked elevation from day 3 post-trauma onward. The difference between MODS and non-MODS patients was significant on days 3, 7, and 14 after acute insults (P < 0.05 or P < 0.01). In addition, serum neopterin levels of patients with fatal outcome were much higher than those of surviving patients, and it exceeded 50.0 nmol/L in most cases prior to termination (8/12 cases, 66.7%).

CONCLUSIONS

Mechanical injury can cause a constant increase in neopterin level, implying an intact reaction by T lymphocytes and macrophage axis. The measurement of serum neopterin might serve as a tool for the evaluation of injury severity, early detection of MODS as well as prediction of outcome in patients after trauma.