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儿童体外循环先天性心脏病手术后常见炎症生物标志物的术后动力学。

Postoperative kinetics of common inflammatory biomarkers after congenital heart defect procedures with extracorporeal circulation in children.

机构信息

Department of Pediatric Cardiac Surgery, St. Adalbertus Hospital, Al. Jana Pawła II 50, 80-462 Gdańsk, Poland.

出版信息

Kardiol Pol. 2018;76(6):968-973. doi: 10.5603/KP.a2018.0038. Epub 2018 Feb 5.

Abstract

BACKGROUND

Extracorporeal circulation is associated with systemic inflammatory response syndrome. Therefore, the diagnosis of infection should be differentiated from a typical postoperative course.

AIM

The aim of the study was to evaluate the kinetics of inflammatory biomarkers in children in the first days after cardiac surgery with extracorporeal circulation.

METHODS

Prospective data were collected from 51 consecutive children referred for surgical treatment in Department of Paediatric Cardiac Surgery, St. Adalbertus Hospital in Gdańsk, between February and August 2015. Blood samples were collected on the first, second, and third postoperative days and sent to the institutional laboratory for routine investigations: white blood cell count, serum C-reactive protein (CRP) and procalcitonin concentrations.

RESULTS

The highest levels of procalcitonin were on the first postoperative day (median 3.53 ng/mL), although the peak values of CRP concentration and white blood cell count were on the second postoperative day (96 mg/L and 17.3 G/L). In the group of patients with foreign material implantation (Contegra® or Gore-Tex®), the higher values of procalcitonin concentration and white blood cell count were measured in the subsequent postoperative days.

CONCLUSIONS

The kinetics of analysed inflammatory biomarkers on the first days after cardiac surgery for congenital heart disease in children have different characteristics. The knowledge about the kinetics of inflammatory biomarkers could be useful in determining the possibility of evolving infections in the early postoperative period.

摘要

背景

体外循环会引起全身炎症反应综合征。因此,应将感染的诊断与典型的术后过程区分开来。

目的

本研究旨在评估体外循环心脏手术后儿童在最初几天的炎症生物标志物的动力学变化。

方法

2015 年 2 月至 8 月期间,连续收集了 51 名在格但斯克圣阿达尔伯特医院儿科心脏外科接受手术治疗的儿童的前瞻性数据。在术后第 1、2 和 3 天采集血样,并送至院内实验室进行常规检查:白细胞计数、血清 C 反应蛋白(CRP)和降钙素原浓度。

结果

降钙素原的最高水平出现在术后第 1 天(中位数 3.53ng/mL),尽管 CRP 浓度和白细胞计数的峰值出现在术后第 2 天(96mg/L 和 17.3G/L)。在植入异物(康特格拉®或戈尔®)的患者组中,术后第 2 天之后,降钙素原浓度和白细胞计数更高。

结论

先天性心脏病儿童体外循环心脏手术后最初几天分析的炎症生物标志物的动力学特征不同。了解炎症生物标志物的动力学特征有助于确定术后早期感染的可能性。

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