Preview

Хирургическая практика

Расширенный поиск

РОЛЬ МАРКЕРОВ СИСТЕМНОГО ВОСПАЛИТЕЛЬНОГО ОТВЕТА В ПОСЛЕОПЕРАЦИОННОМ ПЕРИОДЕ. ОБЗОР

https://doi.org/10.38181/2223-2427-2021-1-30-38

Полный текст:

Аннотация

Несмотря на все достижения современной хирургии количество послеоперационных инфекционных осложнений в мире остается высоким. Их возникновение приводит к удлинению периода госпитализации пациентов, требует применения дополнительных лечебно-диагностических мероприятий, что в конечном итоге ведет к повышению затрат на лечение и значительным финансовым потерям в системе здравоохранения. Поэтому важно выявлять послеоперационные осложнения на ранней стадии, еще до развития выраженных клинических симптомов, предсказывать их возможное развитие у определенной категории пациентов. Для этих целей ученые пытаются использовать различные лабораторные маркеры. В данной работе мы проанализировали как широко известные показатели воспалительного ответа, а именно: С-реактивный белок, альбумин, их соотношение, прокальцитонин и интерлейкин-6, так и относительно новые параметры, которые коллективы исследователей пытаются применить для этих целей: показатели гранулярности и реактивности нейтрофилов, панкреатический каменный белок и панкреатит-ассоциированный белок. Мы постарались собрать наиболее полную информацию, существующую на данный момент, оценить мнения исследователей, выявить противоречия в их работах и попытаться объяснить их причину. В результате оказалось, что даже известные в течение многих лет маркеры воспаления не являются абсолютно специфичными в отношении послеоперационных инфекционных осложнений. Мы пришли к выводу, что большинство из описанных нами лабораторных параметров может быть в той или иной мере использовано в ранней диагностике послеоперационных инфекционных осложнений, однако для получения более полной информации в этой области знаний необходимо проведение новых крупных исследований.

Об авторах

В. А. Кубышкин
Московский государственный университет имени М.В. Ломоносова, факультет фундаментальной медицины (МГУ имени М.В. Ломоносова)
Россия

Кубышкин Валерий Алексеевич – д.м.н., академик РАН, заведующий кафедрой хирургических болезней

119991, г. Москва, ул. Ленинские Горы, д. 1



Л. М. Самоходская
Московский государственный университет имени М.В. Ломоносова, факультет фундаментальной медицины (МГУ имени М.В. Ломоносова); Медицинский научно-образовательный центр МГУ имени М.В. Ломоносова
Россия

Самоходская Лариса Михайловна – к.м.н., доцент, заведующая отделом лабораторной диагностики

119991, г. Москва, ул. Ленинские Горы, д. 1

119192, г. Москва, Ломоносовский проспект, д. 27, к. 10



Ю. М. Королев
Московский государственный университет имени М.В. Ломоносова, факультет фундаментальной медицины (МГУ имени М.В. Ломоносова)
Россия

Королев Юрий Михайлович – студент

119991, г. Москва, ул. Ленинские Горы, д. 1

119192, Москва, Ломоносовский проспект, д. 27, к. 1

+7(962)9054431 



Список литературы

1. Weiser TG, Haynes AB, Molina G, Lipsitz SR, Esquivel MM, Uribe-Leitz T, Fu R, Azad T, Chao TE, Berry WR, Gawande AA. OMS Marzo 2016: Las personas de los países más pobres del mundo no reciben cirugías – estudio. World Heal Organ. 2016;94(November 2015):201–9.

2. Хромова В.Н. Постгоспитальные послеоперационные осложнения в абдоминальной хирургии. 2011, С. 128–35 [Khromova V.N. Posthospital postoperative complications in abdominal surgery. 2011;128-35].

3. Facy O, Paquette B, Orry D, Binquet C, Masson D, Bouvier A, Fournel I, Charles PE, Rat P, Ortega-Deballon P. Diagnostic accuracy of inflammatory markers as early predictors of infection after elective colorectal surgery. Results from the IMACORS study. Ann Surg. 2016;263(5):961–6. https://doi.org/10.1097/SLA.0000000000001303

4. The International Surgical Outcomes Study group. Global patient outcomes after elective surgery: Prospective cohort study in 27 low-, middle – and high-income countries. Br J Anaesth. 2016;117(5):601–9. https://doi.org/10.1093/bja/aew316.

5. GlobalSurg Collaborative. Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study. Lancet Infect Dis. 2018;18(5):516–25. https://doi.org/10.1016/S1473-3099(18)30101-4.

6. Tevis S. E., Cobian A. G., Truong H. P., Craven MW. Modeling the Temporal Evolution of Postoperative Complications. AMIA. Annu Symp proceedings AMIA Symp. 2016;2016(Table 1):551–9.

7. Lagoutte N, Facy O, Ravoire A, Chalumeau C, Jonval L, Rat P, Ortega-Deballon P. C-reactive protein and procalcitonin for the early detection of anastomotic leakage after elective colorectal surgery: pilot study in 100 patients. J Visc Surg. 2012;149(5):e345–9. https://doi.org/10.1016/j.jviscsurg.2012.09.003.

8. O’Malley RB, Revels JW. Imaging of Abdominal Postoperative Complications. Radiol Clin North Am. 2020;58(1):73–91. https://doi.org/10.1016/j.rcl.2019.08.007.

9. Gore RM, Berlin JW, Yaghmai V, Mehta U, Newmark GM, Ghahremani GG. CT diagnosis of postoperative abdominal complications. Semin Ultrasound, CT MRI. 2004;25(3):207–21. https://doi.org/10.1053/j.sult.2004.03.003.

10. Hollis, RH, Graham LA, Lazenby JP, Brown DM, Taylor BB, Heslin MJ, Rue LW, Hawn MT. A role for the early warning score in early identification of critical postoperative complications. Ann Surg. 2016;263(5):918–23. https://doi.org/10.1097/SLA.0000000000001514.

11. Singh PP, Zeng ISL, Srinivasa S, Lemanu DP, Connolly AB, Hill AG. Systematic review and meta-analysis of use of serum C-reactive protein levels to predict anastomotic leak after colorectal surgery. Br J Surg. 2014;101(4):339–46. https://doi.org/10.1002/bjs.9354.

12. Warschkow R, Beutner U, Steffen T, Müller SA, Schmied BM, Güller U, Tarantino I. Safe and early discharge after colorectal surgery due to C-reactive protein: A diagnostic meta-analysis of 1832 patients. Ann Surg. 2012;256(2):245–50. https://doi.org/10.1097/SLA.0b013e31825b60f0.

13. Silvestre J, Rebanda J, Lourenҫo C, Póvoa P. Diagnostic accuracy of C-reactive protein and procalcitonin in the early detection of infection after elective colorectal surgery – a pilot study. BMC Infect Dis. 2014;14(1):1–8. https://doi.org/10.1186/1471-2334-14-444.

14. Facy O, Paquette B, Orry D, Santucci N, Rat P, Rat P, Binquet C, Ortega-Deballon P. Inflammatory markers as early predictors of infection after colorectal surgery: the same cut-off values in laparoscopy and laparotomy? Int J Colorectal Dis. 2017;32(6):857–63. https://doi.org/10.1007/s00384-017-2805-9.

15. Warschkow R, Tarantino I, Ukegjini K, Beutner U, Müller SA, Schmied BM, Steffen T. Diagnostic study and meta-analysis of C-reactive protein as a predictor of postoperative inflammatory complications after gastroesophageal cancer surgery. Langenbeck’s Arch Surg. 2012;397(5):727–36. https://doi.org/10.1007/s00423-012-0944-6.

16. Gans SL, Atema JJ, van Dieren S, Koerkamp BG, Boermeester MA. Diagnostic value of C-reactive protein to rule out infectious complications after major abdominal surgery: a systematic review and meta-analysis. Int J Colorectal Dis. 2015;30(7):861– 73. https://doi.org/10.1007/s00384-015-2205-y.

17. Warschkow R, Tarantino I, Torzewski M, Näf F, Lange J, Steffen T. Diagnostic accuracy of C-reactive protein and white blood cell counts in the early detection of inflammatory complications after open resection of colorectal cancer: A retrospective study of 1,187 patients. Int J Colorectal Dis. 2011;26(11):1405–13. https://doi.org/10.1007/s00384-011-1262-0.

18. Basile-Filho A, Lago AF, Menegheti MG, Nicolini EA, Rodrigues LA, Nunes RS, Auxiliadora-Martins M, Ferez MA. The use of APACHE II, SOFA, SAPS 3, C-reactive protein/albumin ratio, and lactate to predict mortality of surgical critically ill patients: A retrospective cohort study. Medicine (Baltimore). 2019;98(26):e16204. https://doi.org/10.1097/MD.0000000000016204.

19. Ge X, Dai X, Ding C, Tian H, Yang J, Gong J, Zhu W, Li N, Li J. Early Postoperative Decrease of Serum Albumin Predicts Surgical Outcome in Patients Undergoing Colorectal Resection. Dis Colon Rectum. 2017;60(3):326–34. https://doi.org/10.1097/DCR.0000000000000750.

20. Wang Y, Wang H, Jiang J, Cao X, Liu Q. Early decrease in postoperative serum albumin predicts severe complications in patients with colorectal cancer after curative laparoscopic surgery. World J Surg Oncol. 2018;16(1):1–6. https://doi.org/10.1186/s12957-018-1493-4.

21. Müller C, Stift A, Argeny S, Bergmann M, Gnant M, Marolt S, Unger L, Riss S. Delta albumin is a better prognostic marker for complications following laparoscopic intestinal resection for Crohn’s disease than albumin alone – A retrospective cohort study. PLoS One. 2018;13(11):1–11. https://doi.org/10.1371/journal.pone.0206911.

22. Hübner M, Mantziari S, Demartines N, Pralong F, CotiBertrand P, Schäfer M. Postoperative Albumin Drop Is a Marker for Surgical Stress and a Predictor for Clinical Outcome: A Pilot Study. Gastroenterol Res Pract. 2016;2016. https://doi.org/10.1155/2016/8743187.

23. Labgaa I, Joliat GR, Demartines N, Hübner M. Serum albumin is an early predictor of complications after liver surgery. Dig Liver Dis. 2016;48(5):559–61. https://doi.org/10.1016/j.dld.2016.01.004.

24. Labgaa I, Joliat GR, Kefleyesus A, Mantziari S, Schäfer M, Demartines N, Hübner M. Is postoperative decrease of serum albumin an early predictor of complications after major abdominal surgery? A prospective cohort study in a European centre. BMJ Open. 2017;7(4):1–8. https://doi.org/10.1136/bmjopen-2016-013966.

25. Bendersky V, Sun Z, Adam MA, Rushing C, Kim J, Youngwirth L, Turner M, Migaly J, Mantyh CR. Determining the Optimal Quantitative Threshold for Preoperative Albumin Level Before Elective Colorectal Surgery. J Gastrointest Surg. 2017;21(4):692–9. https://doi.org/10.1007/s11605-017-3370-9.

26. Ge X, Cao Y, Wang H, Ding C, Tian H, Zhang X, Gong J, Zhu W, Li N. Diagnostic accuracy of the postoperative ratio of Creactive protein to albumin for complications after colorectal surgery. World J Surg Oncol. 2017;15(1):1–7. https://doi.org/10.1186/s12957-016-1092-1.

27. Ishizuka M, Nagata H, Takagi K, Iwasaki Y, Shibuya N, Kubota K. Clinical Significance of the C-Reactive Protein to Albumin Ratio for Survival After Surgery for Colorectal Cancer. Ann Surg Oncol. 2016;23(3):900–7. https://doi.org/10.1245/s10434-015-4948-7.

28. Shibutani M, Maeda K. Prognostic Significance of the Preoperative Ratio of C-Reactive Protein to Albumin and Neutrophil–Lymphocyte Ratio in Gastric Cancer Patients. World J Surg. 2018;42(6):1819–25. https://doi.org/10.1007/s00268-017-4400-1.

29. Haruki K, Shiba H, Shirai Y, Horiuchi T, Iwase R, Fujiwara Y, Furukawa K, Misawa T, Yanaga K. The C-reactive Protein to Albumin Ratio Predicts Long-Term Outcomes in Patients with Pancreatic Cancer After Pancreatic Resection. World J Surg. 2016;40(9):2254–60. https://doi.org/10.1007/s00268-016-3491-4.

30. Vujic J, Marsoner K, Wienerroither V, Mischinger HJ, Kornprat P. The predictive value of the CRP-to-albumin ratio for patients with pancreatic cancer after curative resection: A retrospective single center study. In Vivo (Brooklyn). 2019;33(6):2071–8. https://doi.org/10.21873/invivo.11706.

31. Kinoshita A, Onoda H, Imai N, Iwaku A, Oishi M, Tanaka K, Fushiya N, Koike K, Nishino H, Matsushima M. The C-Reactive Protein/Albumin Ratio, a Novel Inflammation-Based Prognostic Score, Predicts Outcomes in Patients with Hepatocellular Carcinoma. Ann Surg Oncol. 2015;22(3):803–10. https://doi.org/10.1245/s10434-014-4048-0.

32. Lee JW, Sharma AR, Lee SS, Chun WJ, Kim HS. The C-reactive protein to albumin ratio predicts postoperative complication in patients who undergo gastrectomy for gastric cancer. Heliyon. 2020;6(6):423–31. https://doi.org/10.1016/j.heliyon.2020.e04220.

33. Saito H, Kono Y, Murakami Y, Shishido Y, Kuroda H, Matsunaga T, Fukumoto Y, Osaki T, Ashida K, Fujiwara Y. Prognostic Significance of the Preoperative Ratio of C-Reactive Protein to Albumin and Neutrophil–Lymphocyte Ratio in Gastric Cancer Patients. World J Surg. 2018;42(6):1819–25. https://doi.org/10.1007/s00268-017-4400-1.

34. Sun F, Ge X, Liu Z, Du S, Ai S, Guan W. Postoperative C-reactive protein/albumin ratio as a novel predictor for short-term complications following gastrectomy of gastric cancer. World J Surg Oncol. 2017;15(1):191. https://doi.org/10.1186/s12957-017-1258-5.

35. Toiyama Y, Shimura T, Yasuda H, Fujikawa H, Okita Y, Kobayashi M, Ohi M, Yoshiyama S, Hiro J, Araki T, Inoue Y, Mohri Y, Kusunoki M. Clinical burden of C-reactive protein/albumin ratio before curative surgery for patients with gastric cancer. Anticancer Res. 2016;36(12):6491–8. https://doi.org/10.21873/anticanres.11248.

36. Karayiannis D, Bouloubasi Z, Baschali A, Constantinou D, Daskalaki E, Kalatzis V, Voulgaris S, Botsakis C, Magganas D, Vougas V. Postoperative C-reactive protein to albumin ratio as a diagnostic tool for predicting complications after abdominal surgery. Clin Nutr ESPEN. 2018;24(May):176. https://doi.org/10.1016/j.clnesp.2018.01.021.

37. Spoto S, Valeriani E, Caputo D, Cella E, Fogolari M, Pesce E, Mulè MT, Cartillone M, Costantino S, Dicuonzo G, Coppola R, Ciccozzi M, Angeletti S. The role of procalcitonin in the diagnosis of bacterial infection after major abdominal surgery. Med (United States). 2018;97(3):1–6. https://doi.org/10.1097/MD.0000000000009496.

38. Elyazed MMA, Zaki MES. Value of procalcitonin as a biomarker for postoperative hospital-acquired pneumonia after abdominal surgery. Korean J Anesthesiol. 2017;70(2):177–83. https://doi.org/10.4097/kjae.2017.70.2.177.

39. Muñoz, José Luis, Alvarez MO, Cuquerella V, Miranda E, Picó C, Flores R, Resalt-Pereira M, Moya P, Pérez A, Arroyo A. Procalcitonin and C-reactive protein as early markers of anastomotic leak after laparoscopic colorectal surgery within an enhanced recovery after surgery (ERAS) program. Surg Endosc. 2018;32(9):4003–10. https://doi.org/10.1007/s00464-018-6144-x.

40. Ren H, Ren J, Hu Q, Wang G, Gu G, Li G, Wu X, Hong Z, Li J. Prediction of procalcitonin for postoperative intraabdominal infections after definitive operation of intestinal fistulae. J Surg Res. 2016;206(2):280–5. https://doi.org/10.1016/j.jss.2016.08.055.

41. Tan WJ, Ng W, Sultana R, de Souza N, Chew M, Foo F, Tang C, Tan W. Systematic review and meta-analysis of the use of serum procalcitonin levels to predict intra-abdominal infections after colorectal surgery. International Journal of Colorectal Disease. 2018;33(2):171–80. https://doi.org/10.1007/s00384-017-2956-8.

42. Su’a B, Tutone S, MacFater W, Barazanchi A, Xia W, Zeng I, Hill AG. Diagnostic accuracy of procalcitonin for the early diagnosis of anastomotic leakage after colorectal surgery: a meta-analysis. ANZ J Surg. 2019;90(5):675-680. https://doi.org/10.1111/ans.15291.

43. Takakura Y, Hinoi T, Egi H, Shimomura M, Adachi T, Saito Y, Tanimine N, Miguchi M, Ohdan H. Procalcitonin as a predictive marker for surgical site infection in elective colorectal cancer surgery. Langenbeck’s Arch Surg. 2013;398(6):833–9. https://doi.org/10.1007/s00423-013-1095-0.

44. Giaccaglia V, Salvi PF, Cunsolo G V., Sparagna A, Antonelli MS, Nigri G, Balducci G, Ziparo V. Procalcitonin, as an early biomarker of colorectal anastomotic leak, facilitates enhanced recovery after surgery. J Crit Care. 2014;29(4):528–32. https://doi.org/10.1016/j.jcrc.2014.03.036.

45. Giaccaglia V, Salvi PF, Antonelli MS, Nigri G, Pirozzi F, Casagranda B, Giacca M, Corcione F, De Manzini N, Balducci G, Ramacciato G. Procalcitonin reveals early dehiscence in colorectal surgery. the PREDICS study. Ann Surg. 2016;263(5):967–72. https://doi.org/10.1097/SLA.0000000000001365.

46. Zielińska-Borkowska U, Dib N, Tarnowski W, Skirecki T. Monitoring of procalcitonin but not interleukin-6 is useful for the early prediction of anastomotic leakage after colorectal surgery. Clin Chem Lab Med. 2017;55(7):1053–9. https://doi.org/10.1515/cclm-2016-0736.

47. Saeed K, Dale AP, Leung E, Cusack T, Mohamed F, Lockyer G, Arnaudov S, Wade A, Moran B, Lewis G, Dryden M, Cecil T, Cepeda JA. Procalcitonin levels predict infectious complications and response to treatment in patients undergoing cytoreductive surgery for peritoneal malignancy. Eur J Surg Oncol. 2016;42(2):234–43. https://doi.org/10.1016/j.ejso.2015.10.004.

48. Meyer ZC, Schreinemakers JMJ, Mulder PGH, Schrauwen L, De Waal RAL, Ermens AAM, Van Der Laan L. Procalcitonin in the recognition of complications in critically ill surgical patients. J Surg Res. 2014;187(2):553–8. https://doi.org/10.1016/j.jss.2013.10.051.

49. Yuan SM. Interleukin-6 and cardiac operations. Eur Cytokine Netw. 2018;29(1):1–15. https://doi.org/10.1684/ecn.2018.0406.

50. Szczepanik AM, Scislo L, Scully T, Walewska E, Siedlar M, Kolodziejczyk P, Lenart M, Rutkowska M, Galas A, Czupryna A, Jan K. IL-6 serum levels predict postoperative morbidity in gastric cancer patients. Gastric Cancer. 2011;14(3):266–73. https://doi.org/10.1007/s10120-011-0039-z.

51. Zhang D, Ren J, Arafeh MO, Sawyer RG, Hu Q, Wu X, Wang G, Gu G, Hu J, Li M. The Significance of Interleukin-6 in the Early Detection of Surgical Site Infections after Definitive Operation for Gastrointestinal Fistulae. Surg Infect (Larchmt). 2018;19(5):523–8. https://doi.org/10.1089/sur.2017.271.

52. Rettig TCD, Verwijmeren L, Dijkstra IM, Boerma D, Van De Garde EMW, Noordzij PG. Postoperative interleukin- 6 level and early detection of complications after elective major abdominal surgery. Ann Surg. 2016;263(6):1207–12. https://doi.org/10.1097/SLA.0000000000001342.

53. Ma L, Zhang H, Yin Y ling, Guo W zhi, Ma Y qun, Wang Y bo, Shu C, Dong L qiang. Role of interleukin-6 to differentiate sepsis from non-infectious systemic inflammatory response syndrome. Cytokine. 2016;88:126–35. https://doi.org/10.1016/j.cyto.2016.08.033.

54. Jekarl DW, Lee SY, Lee J, Park YJ, Kim Y, Park JH, Wee JH, Choi SP. Procalcitonin as a diagnostic marker and IL-6 as a prognostic marker for sepsis. Diagn Microbiol Infect Dis. 2013;75(4):342– 7. https://doi.org/10.1016/j.diagmicrobio.2012.12.011.

55. Mat-Nor MB, MD Ralib A, Abdulah NZ, Pickering JW. The diagnostic ability of procalcitonin and interleukin-6 to differentiate infectious from noninfectious systemic inflammatory response syndrome and to predict mortality. J Crit Care. 2016;33(2015):245–51. https://doi.org/10.1016/j.jcrc.2016.01.002.

56. Song J, Park DW, Moon S, Cho HJ, Park JH, Seok H, Choi WS. Diagnostic and prognostic value of interleukin-6, pentraxin 3, and procalcitonin levels among sepsis and septic shock patients: a prospective controlled study according to the Sepsis-3 definitions. BMC Infect Dis. 2019;19(1):968. https://doi.org/10.1186/s12879-019-4618-7.

57. Mokart D, Merlin M, Sannini A, Brun JP, Delpero JR, Houvenaeghel G, Moutardier V, Blache JL. Procalcitonin, interleukin 6 and systemic inflammatory response syndrome (SIRS): Early markers of postoperative sepsis after major surgery. Br J Anaesth. 2005;94(6):767–73. https://doi.org/10.1093/bja/aei143.

58. Sysmax WHITE PAPER INFECTION / INFLAMMATION Novel haematological parameters for rapidly monitoring the immune system response. 2017. p. 1–5.

59. Luo Y, Lin J, Chen H, Zhang J, Peng S, Kuang M. Utility of neut-X, neut-Y and neut-Z parameters for rapidly assessing sepsis in tumor patients. Clin Chim Acta. 2013;422:5–9. https://doi.org/10.1016/j.cca.2013.03.026.

60. Park SH, Park CJ, Lee BR, Nam KS, Kim MJ, Han MY, Kim YJ, Cho YU, Jang S. Sepsis affects most routine and cell population data (CPD) obtained using the Sysmex XN-2000 blood cell analyzer: Neutrophil-related CPD NE-SFL and NE-WY provide useful information for detecting sepsis. Int J Lab Hematol. 2015;37(2):190–8. https://doi.org/10.1111/ijlh.12261.

61. Henriot I, Launay E, Boubaya M, Cremet L, Illiaquer M, Caillon H, Desjonquères A, Gillet B, Béné MC, Eveillard M. New parameters on the hematology analyzer XN-10 (SysmexTM) allow to distinguish childhood bacterial and viral infections. Int J Lab Hematol. 2017;39(1):14–20. https://doi.org/10.1111/ijlh.12562.

62. Cornet E, Boubaya M, Troussard X. Letter To The Editor: Contribution of the new XN-1000 parameters NEUT-RI and NEUT-WY for managing patients with immature granulocytes. Int J Lab Hematol. 2015;37:e23–6. https://doi.org/10.1111/ijlh.12372.

63. Eggimann P, Que YA, Rebeaud F. Measurement of pancreatic stone protein in the identification and management of sepsis. Biomark Med. 2019;13(2):135–45. https://doi.org/10.2217/bmm-2018-0194.

64. Gukasjan R, Raptis DA, Schulz HU, Halangk W, Graf R. Pancreatic Stone protein predicts outcome in patients with peritonitis in the ICU. Crit Care Med. 2013;41(4):1027–36. https://doi.org/10.1097/CCM.0b013e3182771193.

65. Keel M, Härter L, Reding T, Sun LK, Hersberger M, Seifert B, Bimmler D, Graf R. Pancreatic stone protein is highly increased during posttraumatic sepsis and activates neutrophil granulocytes. Crit Care Med. 2009;37(5):1642–8. https://doi.org/10.1097/CCM.0b013e31819da7d6.

66. Llewelyn MJ, Berger M, Gregory M, Ramaiah R, Taylor AL, Curdt I, Lajaunias F, Graf R, Blincko SJ, Drage S, Cohen J. Sepsis biomarkers in unselected patients on admission to intensive or high-dependency care. Crit Care. 2013 Mar;17(2). https://doi.org/10.1186/cc12588.

67. Que Y, Delodder F, Guessous I, Graf R, Bain M, Calandra T, Liaudet L, Eggimann P. Pancreatic stone protein as an early biomarker predicting mortality in a prospective cohort of patients with sepsis requiring ICU management. BMC Crit care. 2012;4. https://doi.org/10.1186/cc11406.

68. Li L, Bachem MG, Zhou S, Sun Z, Chen J, Siech M, Bimmler D, Graf R. Pancreatitis-associated protein inhibits human pancreatic stellate cell MMP-1 and -2, TIMP-1 and -2 secretion and RECK expression. Pancreatology. 2009;9(1–2):99–110. https://doi.org/10.1159/000178880.

69. Nunes T, Etchevers MJ, Sandi MJ, Donnay SP, Grandjean T, Pellisé M, Panés J, Ricart E, Iovanna JL, Dagorn JC, Chamaillard M, Sans M. Pancreatitis-associated protein does not predict disease relapse in inflammatory bowel disease patients. PLoS One. 2014;9(1):5–11. https://doi.org/10.1371/journal.pone.0084957.

70. Cao G, Ma J, Zhang Y, Liu B, Li F. Pancreatits-associated protein is related closely to neoplastic proliferative activity in patients with colorectal carcinoma. Anat Rec. 2009;292(2):249–53. https://doi.org/10.1002/ar.20806.


Для цитирования:


Кубышкин В.А., Самоходская Л.М., Королев Ю.М. РОЛЬ МАРКЕРОВ СИСТЕМНОГО ВОСПАЛИТЕЛЬНОГО ОТВЕТА В ПОСЛЕОПЕРАЦИОННОМ ПЕРИОДЕ. ОБЗОР. Хирургическая практика. 2021;(1):30-38. https://doi.org/10.38181/2223-2427-2021-1-30-38

For citation:


Kubyshkin V.A., Samokhodskaya L.M., Korolev Yu.M. THE ROLE OF MARKERS OF SYSTEMIC INFLAMMATORY RESPONSE IN THE POSTOPERATIVE PERIOD. REVIEW. Surgical practice. 2021;(1):30-38. (In Russ.) https://doi.org/10.38181/2223-2427-2021-1-30-38

Просмотров: 89


Creative Commons License
Контент доступен под лицензией Creative Commons Attribution 4.0 License.


ISSN 2223-2427 (Print)