2018 Fiscal Year Final Research Report
What is the difference between postoperative systemic inflammatory response syndrome and surgical site infection in orthopaedic surgery?
| Project/Area Number |
16K10807
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Orthopaedic surgery
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| Research Institution | Tohoku University |
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Principal Investigator |
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| Co-Investigator(Kenkyū-buntansha) |
久志本 成樹 東北大学, 医学系研究科, 教授 (50195434)
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| Project Period (FY) |
2016-04-01 – 2019-03-31
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| Keywords | バイオマーカー / 合併症 / 早期診断 / 感染症 / 侵襲 / プレセプシン / 脊椎 / 手術 |
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| Outline of Final Research Achievements |
Perioperative kinetics of presepsin (PSEP), as a novel diagnostic biomarker for bacterial sepsis and mitochondrial DNA (mtDNA), as a damage-associated molecular pattern in patients undergoing spinal surgery were measured. In patients without postoperative infection, the median PSEP value was 126, 171, 194, and 147 pg/mL, the median mtDNA level was 0.08, 0.21, 0.11, and 0.12 μg/mL, before, immediately after, 1 day after, and 1 week after surgery, respectively. Compared with the preoperative value, mtDNA was significantly higher immediately after surgery, and return to the preoperative level 1 day after surgery. The estimated reference value for 95 percentile of PSEP in patients without postoperative infection was 297 pg/mL 1 week after surgery. In patients with postoperative infection, higher PSEP levels (＞300pg/mL) were observed 1 week after surgery. The PSEP value of 300pg/mL 1 week after surgery might be used as a novel indicator for suspected postoperative infection.
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| Free Research Field |
整形外科学、救急医学
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| Academic Significance and Societal Importance of the Research Achievements |
人工関節・脊椎固定器械などインプラントを多用する整形外科手術において、術後創傷感染症の早期診断は重要であるが、生体に手術侵襲が加わると感染を合併していなくても全身性炎症反応が生じるため、容易ではない。
本研究では、新しい敗血症診断マーカーであるプレセプシンの整形外科予定手術における周術期動態を調査し、基準値を策定するとともに、プレセプシンが術後創傷感染症の早期診断に有用なバイオマーカーであることを明らかにした。
また、細胞死によって細胞外に遊離して炎症を惹起するダメージ関連分子パターンであるミトコンドリアDNAが、手術侵襲により術直後に高値を示し、術翌日には術前レベルに低下することを明らかにした。
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