可溶性尿激酶受体水平不受麻醉和手术创伤引起的全身炎症反应影响。

Soluble Urokinase Receptor Levels Are Not Affected by the Systemic Inflammatory Response to Anesthesia and Operative Trauma.

作者信息

Laou Eleni, Papagiannakis Nikolaos, Tsiaka Aikaterini, Tsapournioti Stamatina, Chatzikallinikidis Konstantinos, Mantzaflaras Georgios, Karadontas Ioannis, Eugen-Olsen Jesper, Chalkias Athanasios

机构信息

Department of Anesthesiology, Faculty of Medicine, University of Thessaly, Larisa, Greece.

First Department of Neurology, Eginition University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

出版信息

Eur Surg Res. 2022;63(4):249-256. doi: 10.1159/000524433. Epub 2022 Apr 6.

DOI:10.1159/000524433

PMID:35385841

Abstract

INTRODUCTION

Soluble urokinase plasminogen activator receptor (suPAR) is an emerging biomarker of the level of chronic systemic inflammation and the general condition of the patient. We aimed to investigate the impact of general anesthesia and major surgery on perioperative suPAR and C-reactive protein (CRP) levels.

METHODS

This study included patients undergoing elective major noncardiac surgery with an expected duration of ≥2 h under general anesthesia. Inclusion criteria were age ≥18 years and American Society of Anesthesiologists' physical status I-IV. Blood was drawn 30 min prior to induction of anesthesia (preoperatively), as well as 30 min after emergence from anesthesia (postoperatively). Plasma suPAR levels were determined using the suPARnostic® Quick Triage lateral flow assay. CRP measurements were performed by particle-enhanced immunoturbidimetric assay.

RESULTS

The difference in preoperative and postoperative suPAR levels was not statistically significant (7.7 [5.28-10.4] ng/mL vs. 7.15 [5.68-9.8] ng/mL, p = 0.462). CRP levels increased significantly during surgery (0.81 [0.24-2.1] mg/dL vs. 5.76 [2.2-8.75] mg/dL, p < 0.001). No correlation was observed between CRP and suPAR levels, both preoperatively (rho = 0.127; p = 0.208) and postoperatively (rho = 0.017; p = 0.87). A statistically significant increase was also observed in postoperative white blood cell count (7.576 vs. 10.711, p < 0.001).

CONCLUSION

General anesthesia and operative trauma did not affect perioperative suPAR levels despite the activation of systemic inflammatory response.

摘要

引言

可溶性尿激酶型纤溶酶原激活物受体（suPAR）是一种新兴的生物标志物，可反映慢性全身炎症水平及患者的一般状况。我们旨在研究全身麻醉和大手术对围手术期suPAR和C反应蛋白（CRP）水平的影响。

方法

本研究纳入了预计在全身麻醉下进行≥2小时择期非心脏大手术的患者。纳入标准为年龄≥18岁且美国麻醉医师协会身体状况分级为I-IV级。在麻醉诱导前30分钟（术前）以及麻醉苏醒后30分钟（术后）采集血液。使用suPARnostic®快速分诊侧向流动分析法测定血浆suPAR水平。CRP检测采用颗粒增强免疫比浊法。

结果

术前和术后suPAR水平的差异无统计学意义（7.7[5.28 - 10.4] ng/mL对7.15[5.68 - 9.8] ng/mL，p = 0.462）。手术期间CRP水平显著升高（0.81[0.24 - 2.1] mg/dL对5.76[2.2 - 8.75] mg/dL，p < 0.001）。术前（rho = 0.127；p = 0.208）和术后（rho = 0.017；p = 0.87），CRP与suPAR水平之间均未观察到相关性。术后白细胞计数也有统计学意义的显著升高（7.576对10.711，p < 0.001）。