[The expression and clinical implication of advanced oxidized protein products in patients with multiple organ dysfunction syndrome].

OBJECTIVE: To investigate the expression and clinical implication of advanced oxidized protein products (AOPP) in patients with multiple organ dysfunction syndrome (MODS).

METHODS: Serum concentrations of C-reactive protein (CRP) and AOPP were determined in 180 patients with systemic inflammatory response syndrome (SIRS) or MODS (90 patients, respectively). The acute physiology and chronic health evaluation III (APACHE III) scoring system was applied to assess severity of patients' condition. The contents of serum CRP and AOPP in MODS group, SIRS group and normal control group, and also in survivor and dead patients in MODS group were determined and compared. The correlation between CRP and AOPP levels and the correlation between AOPP levels and severity of MODS were also observed. Ninety healthy volunteers who matched with study subjects in age and gender comprised the normal control group.

RESULTS: The CRP [(22.22+/-4.32) mg/L] and AOPP [(130.66+/-18.08) micromol/L] levels in patients with MODS were significantly higher than those in normal control group [(2.38+/-0.89) mg/L and (33.20+/-5.32) micromol/L, respectively] and SIRS group [(5.32+/-1.22) mg/L and (48.58+/-6.03) micromol/L, respectively, all P < 0.05], and were positively correlated with APACHE III scores [(98.66+/-20.87) scores] of the patient (r1 = 0.469, r2 = 0.528, both P < 0.01). However, there was no significant difference between SIRS group and normal control group. The CRP and AOPP levels were found to be significantly higher in the patients who eventually died (47 cases) as compared to those in the patients who survived (43 cases, both P < 0.05). Positive correlations were noted between AOPP and CRP level (r = 0.448, P < 0.01). The serum concentrations of CRP and AOPP levels were elevated with the increase of the number of failed organs in MODS patients(all P < 0.05).

CONCLUSION: The data show that AOPP might participate in the process of pathogenesis of MODS. The serum AOPP level may be taken as a diagnostic and prognostic indicator for MODS.