Haupt W, Hohenberger W, Klein P, Christou N V
Chirurgische Universitätsklinik, Regensburg, Germany.
Infection. 1995 Sep-Oct;23(5):263-6. doi: 10.1007/BF01716282.
Monocytes play a key role in the immune response to trauma and infection. Is monocyte function already altered before surgery in terms of cell activation? On admission, serum neopterin was at or above 9 nmol/l in 50.2% and serum IL-6 was detectable (> 4 pg/ml) in 10.5% of 227 patients electively undergoing major abdominal surgery. Mean values of CRP (0.8 vs. 3.6), alpha-1-antitrypsin (267 vs. 376), albumin (4.0 vs. 3.5), prealbumin (27.0 vs. 17.9, all at p < 0.01) were significantly different in patients with or without monocyte activation (neopterin > 9 nmol/l and IL-6 > 4 pg/ml). There was a significant correlation between neopterin and the acute phase proteins (all at p < 0.01). The data reflect a "primed" state at least of some parts of the immune system in a subgroup of preoperative patients potentially affecting their response to surgical trauma and bacterial contamination.
单核细胞在创伤和感染的免疫反应中起关键作用。就细胞活化而言，单核细胞功能在手术前是否已经改变？在227例择期接受腹部大手术的患者中，入院时50.2%的患者血清新蝶呤水平达到或高于9 nmol/l，10.5%的患者血清白细胞介素-6可检测到（>4 pg/ml）。有或没有单核细胞活化（新蝶呤>9 nmol/l且白细胞介素-6>4 pg/ml）的患者，其C反应蛋白（0.8对3.6）、α-1抗胰蛋白酶（267对376）、白蛋白（4.0对3.5）、前白蛋白（27.0对17.9，均p<0.01）的平均值有显著差异。新蝶呤与急性期蛋白之间存在显著相关性（均p<0.01）。这些数据反映了术前患者亚组中至少部分免疫系统处于“预激”状态，这可能会影响他们对手术创伤和细菌污染的反应。
