IgM, IgA, IgG, and complement components as pre-operative markers for the development of multiple organ dysfunction syndrome in patients with infective endocarditis in early postoperative period

A. Ponasenko, M. Khutornaya, A. Tsepokina, Y. Kudryavtseva
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Abstract

Aim. Here, we studied whether the immunoreactivity in pre-operative period defines early postoperative complications in patients with infective endocarditis (IE).Materials and Methods. We consecutively enrolled 110 patients with subacute IE (80 with native-valve IE and 30 with prosthetic valve IE) who underwent a heart valve replacement, then measuring the levels of IgM, IgA, IgG, and complement components in their serum and evaluating their correlation with an adverse early postoperative outcome.Results. Compared with patients< 50 years of age, those ≥ 50 years of age had 2-foldand 3-foldhigher prevalence of systemic inflammatory response syndrome and multiple organ dysfunction syndrome in the early postoperative period. Notably, these numbers correlated with increased С3d and С5а along with reduced Ig М and IgG. IgМ below 9.5 mg/mL and IgG below 2.0mg/mL indicated a 3-foldhigher risk of multiple organ dysfunction syndrome (OR = 3.07, 95% CI = 1.96-4.04, р=0,001).Conclusion. Serum IgM, IgG, and complements factors C3d and C5a may be used as prognostic markers of multiple organ dysfunction syndrome in the early postoperative period.
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IgM、IgA、IgG和补体成分作为感染性心内膜炎术后早期多器官功能障碍综合征发生的术前标志物
的目标。在这里,我们研究了术前免疫反应性是否决定了感染性心内膜炎(IE)患者术后早期并发症。材料与方法。我们连续招募了110例接受心脏瓣膜置换术的亚急性IE患者(80例为天然瓣膜IE, 30例为人工瓣膜IE),然后测量他们血清中IgM、IgA、IgG和补体成分的水平,并评估它们与术后早期不良预后的相关性。与< 50岁的患者相比,≥50岁的患者术后早期全身性炎症反应综合征和多器官功能障碍综合征的患病率分别高出2倍和3倍。值得注意的是,这些数字与С3d和С5а升高以及IgG М和IgG降低相关。IgМ < 9.5 mg/mL, IgG < 2.0mg/mL提示多器官功能障碍综合征发生风险增加3倍(OR = 3.07, 95% CI = 1.96 ~ 4.04, r = 0.001)。血清IgM、IgG及补体因子C3d、C5a可作为术后早期多脏器功能障碍综合征的预后指标。
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