Objective: To investigate changes in endogenous bactericidal/permeability-increasing protein (BPI) levels and their significance in patients with surgical sepsis.

Methods: In the prospective study, 19 surgical patients with infection were involved. The plasma BPI, lipopolysaccharide-binding protein (LBP) and interleukin-6 levels were measured on post-infected days 1, 3, 5, 7 and 14 by an enzyme-linked immunosorbent assay (ELISA). Plasma endotoxin concentrations were determined by the modified chromogenic Limulus Amebocyte Lysate (LAL).

Results: Compared with normal controls, significant lower plasma BPI/LBP ratios were observed in septic patients on days 1 to 5 after infection (P < 0.01), and in severe septic patients on days 1 to 7 (P < 0.01). Moreover, plasma BPI/LBP ratios were much lower in severe sepsis than those in sepsis on days 1 to 3 after infection (P < 0.05).

Conclusions: Plasma BPI and LBP levels increased rapidly after infection, but BPI/LBP ratios were significantly decreased during sepsis. Plasma BPI/LBP ratios appear to be closely related to the severity of sepsis in patients complicated by surgical infection.

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