Shakespeare P G, Ball A J, Spurr E D
Laing Laboratory, Odstock Hospital, Salisbury, Wilts, UK.
Ann Clin Biochem. 1989 Jan;26 ( Pt 1):49-57. doi: 10.1177/000456328902600107.
Changes in the concentrations of 11 serum proteins following surgery for a variety of conditions have been investigated. Protein changes were analogous to those observed after injury or trauma, but showed differences in the detailed behaviour of the pattern of change. Marked increases in the concentrations of five acute-phase reactant proteins (APRP) were seen, with maximum concentrations usually being reached 2 days after surgery in patients who made an uncomplicated recovery from their operations. Considerable differences were observed between the patterns of change of APRP in patients who developed complications during recovery and in patients who made an uncomplicated recovery from surgery. Concentrations of C-reactive protein and alpha-1 antichymotrypsin (ACT) were much higher in the patients who developed complications, with ACT concentrations providing the clearest separation between the groups. The main factor influencing the changes in APRP during the recovery period appeared to be the development of sepsis. Preoperative concentrations of APRP had no prognostic value for identifying patients at risk of developing complications. The study suggests that the localisation of inflamed tissue involved in the disease processes may influence the detailed behaviour of the acute-phase reactant proteins.
针对多种病症手术后11种血清蛋白浓度的变化进行了研究。蛋白质变化与损伤或创伤后观察到的变化类似，但在变化模式的详细表现上存在差异。观察到5种急性期反应蛋白（APRP）浓度显著升高，术后恢复顺利的患者通常在术后2天达到最高浓度。恢复过程中出现并发症的患者与术后恢复顺利的患者在APRP变化模式上存在显著差异。出现并发症的患者中C反应蛋白和α-1抗糜蛋白酶（ACT）的浓度要高得多，ACT浓度在两组之间提供了最清晰的区分。恢复期影响APRP变化的主要因素似乎是脓毒症的发生。术前APRP浓度对识别有发生并发症风险的患者没有预后价值。该研究表明，疾病过程中炎症组织的定位可能会影响急性期反应蛋白的详细表现。
