先天性心脏病病儿围手术期血清PCT、IL6及CRP的变化规律(1)
[摘要] 目的 觀察先天性心脏病病儿围手术期血清降钙素原(PCT)、白细胞介素6(IL-6)及C反应蛋白(CRP)水平的变化规律。方法 收集2018年6—8月我院收治的63例拟行体外循环下心内直视手术的先天性心脏病病儿，分别于术前以及术后第1、2、3、7天采集静脉血检测血清PCT、IL-6及CRP水平。结果 先天性心脏病病儿血清PCT、IL-6水平在实施体外循环后开始升高，术后第1天达峰值，之后缓慢下降，至术后第7天接近正常水平;CRP水平在术后第2天达峰值，后渐降至正常。术后PCT峰值水平与手术时间相关(r=0.411，P<0.01)，术后第2、3、7天的PCT水平与手术时间也存在相关性(r=0.259～0.286，P<0.05);而术后各时间点IL-6、CRP水平与手术时间均无相关性(P>0.05)。不同年龄、病种、术前N端脑钠肽前体水平的先天性心脏病病儿比较，术后第1、2、3天血清PCT水平差异有统计学意义(Z=2.10～3.78，P<0.05)。结论 血清PCT、IL-6水平在先天性心脏病病儿体外循环术后开始升高，术后第1天达峰值，之后缓慢下降，至术后第7天接近正常水平;而CRP水平在术后第2天达峰值，后渐降至正常。年龄、心功能状态及手术复杂性可影响病儿术后PCT的水平变化。
[关键词] 心脏病;围手术期;降钙素;白细胞介素6;C反应蛋白质;儿童
[中图分类号] R725.411 [文献标志码] A [文章编号] 2096-5532(2020)05-0592-05
doi：10.11712/jms.2096-5532.2020.56.097 [开放科学(资源服务)标识码(OSID)]
[ABSTRACT] Objective To observe the dynamic changes in serum procalcitonin (PCT)， interleukin-6 (IL-6)， and C-reactive protein (CRP) in children with congenital heart disease (CHD) during the perioperative period. Methods Sixty-three children with CHD， who were admitted to our hospital from June to August 2018 and planned to undergo open-heart surgery with extracorporeal circulation， were enrolled in the study. Venous blood samples were collected from the patients before operation and on the first， second， third， and seventh days after operation to measure serum PCT， IL-6， and CRP levels. Results The serum levels of PCT and IL-6 began to increase after extracorporeal circulation， reached their peaks on the first postoperative day， and then decreased slowly until approaching the normal levels on the seventh postoperative day. The CRP level peaked on the second postoperative day and then gradually decreased to the normal level. The peak level of PCT after operation was significantly correlated with operation time (r=0.411，P<0.01)， and the PCT level on the second， third， and seventh days after operation was also significantly correlated with operation time (r=0.259-0.286，P<0.05); neither IL-6 nor CRP level at each time point after operation was significantly correlated with operation time (P>0.05). The serum PCT level on the first， second， third days after operation was significantly different between different age groups， different CHD type groups， and different N-terminal pro-brain natriuretic peptide level groups (Z=2.10-3.78，P<0.05). Conclusion The serum levels of PCT and IL-6 in children with CHD began to increase after extracorporeal circulation， reached their peaks on the first postoperative day， and then decreased slowly until approaching the normal levels on the seventh postoperative day; the CRP level peaked on the second postoperative day and then gradually decreased to the normal level. Age， cardiac function， and surgical complexity are the factors that influence the changes in serum PCT level in CHD children after operation., 百拇医药(刘乃香 曹倩 陈瑞 吕蓓 侯可峰 李自普)
[关键词] 心脏病;围手术期;降钙素;白细胞介素6;C反应蛋白质;儿童
[中图分类号] R725.411 [文献标志码] A [文章编号] 2096-5532(2020)05-0592-05
doi：10.11712/jms.2096-5532.2020.56.097 [开放科学(资源服务)标识码(OSID)]
[ABSTRACT] Objective To observe the dynamic changes in serum procalcitonin (PCT)， interleukin-6 (IL-6)， and C-reactive protein (CRP) in children with congenital heart disease (CHD) during the perioperative period. Methods Sixty-three children with CHD， who were admitted to our hospital from June to August 2018 and planned to undergo open-heart surgery with extracorporeal circulation， were enrolled in the study. Venous blood samples were collected from the patients before operation and on the first， second， third， and seventh days after operation to measure serum PCT， IL-6， and CRP levels. Results The serum levels of PCT and IL-6 began to increase after extracorporeal circulation， reached their peaks on the first postoperative day， and then decreased slowly until approaching the normal levels on the seventh postoperative day. The CRP level peaked on the second postoperative day and then gradually decreased to the normal level. The peak level of PCT after operation was significantly correlated with operation time (r=0.411，P<0.01)， and the PCT level on the second， third， and seventh days after operation was also significantly correlated with operation time (r=0.259-0.286，P<0.05); neither IL-6 nor CRP level at each time point after operation was significantly correlated with operation time (P>0.05). The serum PCT level on the first， second， third days after operation was significantly different between different age groups， different CHD type groups， and different N-terminal pro-brain natriuretic peptide level groups (Z=2.10-3.78，P<0.05). Conclusion The serum levels of PCT and IL-6 in children with CHD began to increase after extracorporeal circulation， reached their peaks on the first postoperative day， and then decreased slowly until approaching the normal levels on the seventh postoperative day; the CRP level peaked on the second postoperative day and then gradually decreased to the normal level. Age， cardiac function， and surgical complexity are the factors that influence the changes in serum PCT level in CHD children after operation., 百拇医药(刘乃香 曹倩 陈瑞 吕蓓 侯可峰 李自普)