A prospective controlled study was conducted in 30 patients with lower extremity atherosclerotic gangrene. Their mean age was 66.1 +/- 9.0 years. Examinations were made before and after high leg amputation. The investigators analyzed the following markers of a systemic inflammatory reaction (SIR): IL-1beta, 6, 8, 10, TNF-alpha, and L-2r. The concentrations of myoglobin (a marker of tissue damage), cortisol and blood glucose (markers of sympathoadrenal system activation), D-dimers (a marker of disseminated intravascular coagulation), C-reactive protein (CRP), lipopolysaccharide-binding protein, and fibrinogen were also measured. The signs of muscle damage (such as elevated myoglobin concentrations), stress, and CRP were detected in patients with atherosclerotic gangrene in the pre- and postoperative periods. The risk of pyoinflammatory complications in the immediate postoperative period may be predicted from the higher levels of acute-phase proteins (CRP), proinflammatory cytokines (IL-6), and myoglobin.
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