Clinical Medicine
The value of serum pro-adrenomedullin for assessing prognosis of patients with closed rupture of small intestine
Xiang Yawei, Xiang Heping, Gao Ming, Li He, Wang Wei
Published 2016-03-10
Cite as Chin J Emerg Med, 2016,25(3): 356-361. DOI: 10.3760/cma.j.issn.1671-0282.2016.03.021
Abstract
ObjectiveTo explore the relationship between preoperative serum pro-adrenomedullin (pro-ADM) in the patients with closed rupture of small intestine, and postoperative secondary abdominal infection, and to study the value of postoperative serum pro-ADM in assessment of severity of postoperative secondary abdominal infection of this patients.
MethodsEighty-five patients with closed rupture of small intestine treated in the emergency surgery from June 2014 to May 2015 were selected. According to the presence of postoperative abdominal infection or not, these patients were divided into infection group and non-infection group. The infection group was further divided into SIRS, sepsis, severe sepsis, septic shock subgroups as per the severity of infection. The levels of serum pro-ADM, interleukin-6 (IL-6), C- reactive protein (CRP) were determined and the acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score was calculated at admission and the first day、the second day and the third day after operation. Comparisons of these biomarkers were carried out to find out the factors associated with postoperative abdominal infection. In addition, ROC curve was used to verify the factors for predicting the abdominal infection of these patients after operation. The relationship between serum levels of pro-ADM and APACHEⅡ score after operation was analyzed. The severity of abdominal infection after operation was assessed with laboratory findings.
ResultsCompared with non-infection group, preoperative and postoperative serum pro-ADM(P=0.03, P<0.01), IL-6(P=0.02, P<0.01) levels and APACHEⅡ scores (P<0.01, P<0.01)were significantly higher in infection group (P<0.05). In the infection groups, the postoperative levels of serum pro-ADM and APACHEⅡscores were increased with the severity of infection increased (r=0.924), and the difference between the groups was statistically significant (P<0.05), but there were no significant differences in IL-6 and CRP levels between two groups.
Conclusion(1)The serum levels of pro-ADM before operation has value in predicting the genesis of abdominal infection in these patients after operation. (2) The serum levels of pro-ADM after operation has value in severity assessment of abdominal infection in these patients after operation.
Key words:
Closed rupture of small intestine; Pro-adrenomedullin; Interleukin -6; C-reactive protein; Infection
Contributor Information
Xiang Yawei
Emergency Department, Second Affiliated Hospital of Anhui Medical University, Hefei 230601, China
Xiang Heping
Gao Ming
Li He
Wang Wei
