The Study Of The Relationship Of Sepsis With High-density Lipoprotein Levels And It's Alternations

OBJECTIVE:To study the relationship between sepsis and the serum level of high density lipoprotein(HDL) in postoperative patients, and to investigate the alternations tendency of HDL during infection.METHODS:The investigation was carried out with prospective design and retrospective analysis。64 patients who had been in ICU more than 7days and required less than 3 days of mechanical ventilation with no statin used were studied, and those who died in 7 days and were infected before operations were excluded. Blood samples were drawn every day to measure the serum HDL,WBC, CRP ect,and the APACHEⅡscores were conducted for all patients. The patient was defined as the sepsis group according to the sepsis criteria, and non-sepsis group.The data of two groups were comparable. With the same basic therapy, the first postoperative day's HDL levels of two groups were analyzed.RESULTS:The concentrations of serum lipoproteins in sepsis group on day 1 was lower than those of the controls (0.79±0.18 VS 0.89±0.15, F=1.45, p=0.019), logistic analysis indicates that the serum HDL level of 1st day after surgery have relationship with the infection after suegery (OR:30.2,p=0.036)。The 1st and second serum levels of HDL were descend dafter suegery,to 3rd day it elevated gradually.But for infected patients the HDL level decreased.Retrospective analysis the serum level of HDL, temperature, white blood cell, CRP of three days before infection.The serum level of HDL was declined one day before infection,while other index were declined that day of infection.CONCLUSIONS:The concentrations of serum HDL of the 1st day after surgery related to the on set of sepsis. The serum level of HDLwas declined before clinical infection.To monitoring the serum HDL level consecutively after surgery would be useful for detecting infection earlier.