Relationship between postoperative early serum levels of serum amyloid A and choline esterase and postoperative infection in patients with chest trauma

WANG Zhuo-fu; YAN Shen-chao; ZHANG Xu-hong; ZHU Tie-yuan

doi:10.16048/j.issn.2095-5561.2025.01.11

Abstract：Objective To explore the relationship between postoperative early serum levels of Serum amyloid A(SAA)and choline esterase(ChE)and postoperative infection in patients with chest trauma.Methods A total of 114 patients with chest trauma who underwent surgical treatment in Jianli People's hospital from December 2021 to May 2023 were collected.There were 58 males and 56 females,age(46.23±5.86)years,age range 33-60 years.The level of SAA,ChE,C-reactive protein(CRP),procalcitonin,tumour necrosis factor-α(TNF-α),neutrophil/lymphocyte count(NLR),platelet count/lymphocyte count(PLR),platelet countxneutrophil count/lymphocyte count(SII),neutrophil granulocyte count(NEUT),lymphocyte count(LYM)were tested on day 1 preoperatively and day 2 postoperatively.Patients were assessed for secondary infections 7 d postoperatively.Results At 7d postoperatively,there were 39 patients with secondary infections and 75 patients without secondary infections.The levels of NLR,SII,NEUT,CRP,procalcitonin,and TNF-α were lower in patients without secondary infection than in patients with secondary infection,and the levels of PLR and LYM were higher than those in patients with secondary infection,with statistically significant differences(P＜0.05).On postoperative day 2,SAA levels were higher in patients with secondary infection than in patients without secondary infection,and ChE levels were lower than in patients without secondary infection(P＜0.05).At 7d postoperatively,there were 18 patients with mild infection,13 patients with moderate infection,and 8 patients with severe infection.Comparison of SAA and ChE levels in mildly infected patients,moderately infected patients and severely infected patients showed statistically significant differences(P＜0.05).Elevated serum SAA,CRP,and procalcitoninlevels were independent risk factors affecting patients postoperative infections(P＜0.05),and elevated serum ChE was an independent protective factor affecting patients postoperative infections(P＜0.05).The area under the curve for the combined prediction was significantly greater than that for serum SAA and ChE alone(P＜0.05).A positive correlation between serum SAA levels and CRP,procalcitoninand TNF-α(P＜0.05),anegative correlation ChE levels and CRP,procalcitoninand TNF-α(P＜0.05).Conclusion Elevated serum SAA levels and decreased ChE levels in patients with postoperative chest trauma infections.The postoperative early serum levels of SAA and ChE in patients with chest trauma have certain prediction value for postoperative infection.