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接受体外循环心脏手术患儿血清中的白细胞介素-6和降钙素原

Interleukin-6 and procalcitonin in serum of children undergoing cardiac surgery with cardiopulmonary bypass.

作者信息

Hammer Stefanie, Fuchs Alexandra T, Rinker Carsten, Daebritz Sabine, Kozlik-Feldmann Rainer, Netz Heinrich

机构信息

Department of Paediatric Cardiology and Intensive Care Medicine, Ludwig-Maximilians-University, Munich, Germany.

出版信息

Acta Cardiol. 2004 Dec;59(6):624-9. doi: 10.2143/AC.59.6.2005245.

Abstract

OBJECTIVE

The aim of our study was to investigate the systemic inflammatory response in children with congenital heart disease undergoing surgical correction with cardiopulmonary bypass. We wanted to discuss interleukin 6 and procalcitonin as components of the systemic inflammatory response syndrome to cardiopulmonary bypass and evaluate postoperative kinetics of these parameters in case of an uncomplicated course.

METHODS

Procalcitonin and interleukin 6 were determined before and after cardiopulmonary bypass surgery in 37 children on the day of surgery, the first and fourth postoperative day. The increased procalcitonin and interleukin 6 levels were evaluated in relationship to intraoperative variables such as duration of aortic cross clamping, incisional trauma and cardiac bypass temperature.

RESULTS

Peak levels of procalcitonin were detected on the first postoperative day, while interleukin 6 reached its highest values on the day of surgery. In contrast to interleukin 6 the median values of procalcitonin differed significantly between short versus long aortic clamping time and atriotomy versus ventriculotomy. Interleukin 6 reached normal levels on the fourth postoperative day, while procalcitonin was still clearly above normal.

CONCLUSIONS

Serum concentrations of procalcitonin and interleukin 6 were influenced by systemic inflammatory response syndrome following cardiac surgery with cardiopulmonary bypass. Even in case of an uncomplicated course both parameters were elevated for at least four days. While procalcitonin serum concentrations were dependent on aortic clamping time or incisional trauma, interleukin 6 showed no significant relation with these intraoperative variables.

摘要

目的

我们研究的目的是调查接受体外循环手术矫正的先天性心脏病患儿的全身炎症反应。我们想探讨白细胞介素6和降钙素原作为体外循环全身炎症反应综合征的组成部分,并评估在无并发症情况下这些参数的术后动力学变化。

方法

在37例患儿体外循环手术前、手术当天、术后第1天和第4天测定降钙素原和白细胞介素6。根据主动脉阻断时间、切口创伤和体外循环温度等术中变量评估降钙素原和白细胞介素6水平的升高情况。

结果

降钙素原峰值在术后第1天检测到,而白细胞介素6在手术当天达到最高值。与白细胞介素6不同,降钙素原的中位数在短时间与长时间主动脉阻断时间以及心房切开术与心室切开术之间存在显著差异。白细胞介素6在术后第4天恢复正常水平,而降钙素原仍明显高于正常水平。

结论

体外循环心脏手术后全身炎症反应综合征影响降钙素原和白细胞介素6的血清浓度。即使在无并发症的情况下,这两个参数至少4天都会升高。降钙素原血清浓度取决于主动脉阻断时间或切口创伤,而白细胞介素6与这些术中变量无显著关系。

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