Evaluation of immune cell functions in patients with postoperative complications using proteome and metabolome analysis.

免疫细胞功能在大手术后危重疾病发病机制中的作用进行了前瞻性研究。肝胆胰术后并发症的发生机制是多因素的。DAMPS在肝切除后器官功能障碍的发病机制中起主要作用，而术后感染则取决于胰腺的外分泌功能。术后感染患者大手术后外周血中P2X7基因表达水平和T-bet/GATA-3比值显著降低，提示术后早期高表达的P2X7和Th1对细菌感染有保护作用。外周血单核细胞TLRs基因表达在第3天及以后升高。这些结果表明，DAMPS和PAMPS信号在大手术后并发症的发病机制中起着关键作用。

The role of immune cells function in pathogenesis of postoperative critical illness following major surgery was prospectively investigated. The mechanism of postoperative complications following hepato-biliary-pancreatic surgery is multifactorial. DAMPs play a major role in pathogenesis of organ dysfunction following liver resection, whereas postoperative infection depends on exocrine function of the pancreas in patients undergoing pancreatticoduodenectomy. P2X7 mRNA levels and T-bet/GATA-3 ratios in PBMC significantly decrease after major surgery in patients with postoperative infection, suggesting that high expression of P2X7 and Th1 have protective effects against bacterial infection in early postoperative period. TLRs mRNA levels in PBMC increased on day 3 and afterwards. These results suggest that DAMPs and PAMPs signals play a pivotal role in pathogenesis of postoperative complications following major surgery.