Diagnostic Value Of Soluble Urokinase-type Plasminogen Activator Receptor In Postoperative Sepsis In Patients With Traumatic Rupture Of Colon

Background:With the rapid development of economy and society in our country,the automobile industry,transportation industry,infrastructure and other industries have developed rapidly.The number of patients with abdominal trauma has increased year by year.When the colon ruptured,the intestinal contents and bacteria entered the abdominal cavity.Postoperative abdominal infection risk is high,once sepsis occurs,the mortality will be significantly increased.Therefore,how to predict sepsis in patients with traumatic rupture of colon early and evaluate the severity of sepsis is very important for the treatment of this kind of patients after operation.Objective:Serum levels of soluble urokinase-type plasminogen activator receptor(soluble urokinase plasminogen activator receptor,suPAR)were monitored dynamically in patients with traumatic colon rupture.To investigate the relationship between early serum suPAR level and postoperative sepsis,and to evaluate the value of serum suPAR level in evaluating the severity of postoperative sepsis.Method:From March 2016 to September 2017,55 patients with traumatic colon rupture,including 37 males and 18 females,were admitted to the Department of Emergency surgery of the second affiliated Hospital of Anhui Medical University.The patients were divided into non-sepsis group and sepsis group according to whether sepsis occurred or not.Sepsis group was divided into sepsis non-shock group and septic shock group according to its severity.Serum suPAR,interleukin-6,C-reactive protein and acute physiological and chronic health(Acute physiology and chronic ? scores were measured before and at 24 h and 48 h and 72 h after operation,respectively.To analyze the difference of indexes and study their early predictive value for postoperative sepsis.Results:1.There were significant differences in serum suPAR,CRP,IL-6 level and APACHE ?score between the two groups before and after operation(P< 0.05).The serum suPAR levels of patients at admission and after operation were significantly higher than those in non-sepsis patients,and the difference was statistically significant.2.The serum suPAR level in septic shock group was significantly higher than that in non-septic shock group after operation(14.48 ±3.99)ng/ml vs.(8.47 ±3.14)ng/ml,P <0.05).Serum suPAR levels increased with the severity of sepsis.3.The serum suPAR,IL-6,CRP level and APACHE ? score of 55 patients with sepsis before and 24 hours after operation were predicted by the ROC curve.The AUC of suPAR was 0.873 ±0.867,respectively.The corresponding optimal truncation values are? 5.89 ?g/Land ? 5.45 ?g/L,respectively.The AUC of IL-6 was 0.731ng/L and 0.729,respectively,and the corresponding optimum truncation values were ? 79.21ng/L and ?100.21 ng /L,respectively.The AUC of CRP is 0.624/0.593.The corresponding best truncation value is ? 42.68 mg/L,the AUC of Apache ? score?48.10 mg/L is0.809/0.814,and the corresponding best truncation value is?10and?11respectively.According to the ROC curve of four indexes predicting postoperative sepsis,the predictive value of suPAR before and 24 hours after operation was significantly higher than that of IL-6,CRP,slightly better than Apache ? score.Conclusion:1.The level of serum suPAR in patients with traumatic colon rupture has early predictive value for postoperative sepsis.2.The level of serum suPAR in patients with traumatic rupture of colon has a certain value in evaluating the severity of sepsis after operation.