Suzuki Satoru, Haga Y, Hashizume K, Murayama A, Ishikawa S, Takahashi A, Kanki H, Kume A, Kuwabara S
Department of Cardiovascular Surgery, Saitama Municipal Hospital, Saitama, Japan.
Kyobu Geka. 2006 Dec;59(13):1146-53.
The aim of this study is to clarify the relationship between CRP and postoperative infection after cardiovascular surgery. We had 5 cases of surgical site infection, and 3 cases of infective endocarditis (IE) among 57 patients selected for this study out of 405 patients who had undergone cardiovascular surgery from May 1995 to March 2005. CRP, WBC and body temperature (BT) were evaluated during 1 week after the operation. Our results showed not only that the mean value of CRP level in the 49 non-infection patients attained the peak on the 2nd or 3rd day after the operation (18.2 +/- 4.7 and 17.7 +/- 5.7 mg/dl), but also that each patient in this group showed the same pattern of CRP sequence. CRP in the 5 cases of postoperative infection showed different patterns from that in the non-infection group. CRP in 3 cases of valve replacement for IE showed significantly higher level than that in 16 cases of valve replacement without IE through 1 week after the surgery. WBC level in the non-infection group reached the peak just after the operation (11.3 +/- 4.4 x 10(3)/microl) and then decreased gradually during 1 week after the operation. WBC in the 3 cases of valve replacement for IE, did not show different sequence pattern from that in the 16 cases of valve replacement without IE. WBC in a case of postoperative mediastinal infection showed a similar pattern of sequence to that in the non-infection group although it showed a remarkably high level of CRP sequence through 1 week after the surgery. BT in the non-infection group became the lowest just after the operation and reached the peak 8 hours after the operation. It then decreased gradually during 1 week after the operation. Our study demonstrates that CRP sequence after the surgery might be useful to detect postoperative infection after cardiovascular surgery.
本研究的目的是阐明心血管手术后CRP与术后感染之间的关系。在1995年5月至2005年3月接受心血管手术的405例患者中,我们选取了57例患者进行本研究,其中有5例手术部位感染,3例感染性心内膜炎(IE)。在术后1周内对CRP、白细胞(WBC)和体温(BT)进行评估。我们的结果显示,不仅49例未感染患者的CRP水平平均值在术后第2天或第3天达到峰值(18.2±4.7和17.7±5.7mg/dl),而且该组中的每位患者都表现出相同的CRP变化模式。5例术后感染患者的CRP模式与未感染组不同。3例因IE进行瓣膜置换的患者术后1周内的CRP水平明显高于16例无IE进行瓣膜置换的患者。未感染组的WBC水平在术后即刻达到峰值(11.3±4.4×10³/μl),然后在术后1周内逐渐下降。3例因IE进行瓣膜置换的患者的WBC变化模式与16例无IE进行瓣膜置换的患者没有差异。1例术后纵隔感染患者的WBC变化模式与未感染组相似,尽管其术后1周内的CRP水平明显较高。未感染组的BT在术后即刻降至最低,术后8小时达到峰值,然后在术后1周内逐渐下降。我们的研究表明,术后CRP变化模式可能有助于检测心血管手术后的术后感染。