Modulation of plasma fibrinogen levels in acute-phase response after hepatectomy
Modulation of plasma fibrinogen levels in acute-phase response after hepatectomy
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DOI：
10.1515/cclm.2004.048
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发表时间：
2004-01-01
影响因子：
6.8
通讯作者：
Nuzzo, G
中科院分区：
文献类型：
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作者：
Giovannini, I;Chiarla, C;Nuzzo, G
在急性时相反应中，氨基酸的使用被重新定向到支持用于宿主防御和组织修复的蛋白质的合成。纤维蛋白原就是这些蛋白质中的一种，它的血浆水平通常在急性时相条件下升高。肝切除术后，这种模式可能会被术后肝功能障碍的不同影响所改变。我们的研究就是为了具体评估和量化这一方面。前瞻性收集了82例肝切除患者的数据；62例恢复正常，20例有严重并发症(最常见的是脓毒症)。所有患者均于术前、术后第1、3、7天测定血浆纤维蛋白原及一系列辅助指标，有并发症者至痊愈或死亡。多元回归分析显示，术后纤维蛋白原变化与切除肝段数(NSEG)、总胆红素(BIL)、天冬氨酸氨基转移酶(U/L)、总胆红素(BIL)同时相关。545)，白蛋白(g/L)，凝血酶原活动度(PA，标准参考值的%)，年龄(年龄，年限)和术前基础纤维蛋白原(PfIB，Mumol/L)：DeltaFIB=-0.51(NSEG)-0.71(Log(N)BIL)-0.74(Log(N)AST)+0.11(ALB)+0.09(PA)-0.06(AGE)-0.55(PfIB)+7.74(n=362，r(2)=0.68，p
In acutephase response, the use of amino acids is redirected to supporting the synthesis of proteins for host defence and tissue repair. Fibrinogen is one of these proteins, and its plasma levels commonly increase in acutephase conditions. After hepatectomy, this pattern may be modified by the variable impact of postoperative liver dysfunction. Our study was performed to specifically assess and quantify this aspect. Data were collected prospectively on 82 hepatectomized patients; 62 recovered normally, 20 had major complications (most commonly sepsis). Plasma fibrinogen and a large series of complementary variables were determined preoperatively and at postoperative days 1, 3 and 7 in all patients and until recovery, or death in those with complications. Multiple regression analysis showed that postoperative changes in fibrinogen (DeltaFIB, mumol/l) were simultaneously related to the number of resected liver segments (NSEG), total bilirubin (BIL, mumol/l), aspartate aminotransferase (AST, U/l, n.v. 545), albumin (ALB, g/l), prothrombin activity (PA, % of standard reference), age (AGE, years) and basal preoperative fibrinogen (PFIB, mumol/l): DeltaFIB= -0.51 (NSEG) -0.71 (Log(n)BIL) -0.74(Log(n)AST)+0.11(ALB) +0.09(PA) -0.06 (AGE) -0.55(PFIB)+7.74 (n=362, r(2)=0.68, p