J.Jpn. Surg. Soc.. 92(2): 181-186, 1991

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Original article

POSTOPERATIVE CHANGE OF SERUM PROTEASE INHIBITOR AND C-REACTIVE PROTEIN LEVEL
―WITH SPECIAL REFERENCE TO SURGICAL RESECTION OF LIVER CIRRHOSIS―

Changes in the activities of blood protease inhibitors and acute･phase reactive substances during surgical resection of liver cirrhosis were investigated by measuring the pre-and postoperative blood concentrations of α₁-antitrypsin (α₁AT), α₂-macroglobulin (α₂MG), pancreatic secretory trypsin inhibitor (PSTI), urinary trypsin inhibitor (UTI) and C-reactive protein (CRP), in patients with liver cirrhosis who underwent hepatectomy (Group A, n=19), those without liver cirrhosis who underwent hepatectomy (Group B, n=6) and those without liver cirrhosis who underwent surgeries other than hepatectomy (Group C, n=5).
On examining the preoperative blood levels of protease inhibitors, Group A had an increased level of a₂MG and adecreased level of UTI compared to Groups B and C.
α₁AT and CRP began to increase on the first day following hepatectomy and formed peaks on the third postoperative day. The increases were significantly higher in Group B than Group A (p＜0.01). To investigate factors causative of these differences, α₁AT and CRP on the third postoperative day were compared in relation to the time of operation, amount of intraoperative bleeding,weight of the resected liver and preoperative ICGR₁₅.α₁AT and CRP were significantly correlated to only preoperative ICGR₁₅. PSTI was increased postoperatively but showed no difference between Groups A and B.

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