论文部分内容阅读
目的探讨围术期肺部感染先天性心脏病(先心病)小儿CD64的表达及临床意义。方法先心病患儿201例在心肺转流(CPB)下行心脏畸形手术矫正。非青紫型先心病164例,术前有肺部感染31例,术后12例;青紫型先心病37例,术前有肺部感染5例,术后6例。健康小儿20例作为对照。采用流式细胞术检测血清CD64表达。结果与健康小儿相比,无肺部感染的患儿CD64表达稍高(P>0.05),而有肺部感染患儿的CD64的表达上升(P<0.05),随着先心病术的实施,术前出现感染的患儿的CD64表达下降(P<0.05)。非青紫型和青紫型先心病有肺部感染患儿的CD64表达水平无统计学差异(P>0.05)。术后发生呼吸机相关性肺炎15例,其CD64表达在术后24~48h呈上升趋势,且随着患儿呼吸机时间的延长相应上升。结论对先心病患儿围术期以CD64表达作为评估术后呼吸机相关性肺炎感染风险的临床指标之一有一定的应用价值,以便适时有效进行抗生素干预,有利于患儿的康复。
Objective To investigate the expression and clinical significance of CD64 in children with congenital heart disease (CHD) after perioperative pulmonary infection. Methods 201 cases of children with congenital heart disease in cardiopulmonary bypass (CPB) surgical correction of cardiac deformity. There were 164 cases of non-cyanosis congenital heart disease, 31 cases of pulmonary infection preoperatively, 12 cases postoperatively, 37 cases of cyanotic congenital heart disease, 5 cases of preoperative pulmonary infection and 6 cases postoperatively. 20 healthy children as a control. Serum CD64 expression was detected by flow cytometry. Results Compared with healthy children, the expression of CD64 in children without pulmonary infection was slightly higher (P> 0.05), while the expression of CD64 in children with pulmonary infection was higher (P <0.05). With the implementation of congenital heart disease, Preoperative infection in children with CD64 expression decreased (P <0.05). There was no significant difference in the expression level of CD64 in children with non-cyanobacteria and cyanotic congenital heart disease with pulmonary infection (P> 0.05). Fifteen cases of ventilator-associated pneumonia occurred after operation, and the expression of CD64 increased from 24 to 48 hours after operation, and increased with the prolongation of ventilator time. Conclusion Perioperative CD64 expression in children with congenital heart disease as a clinical evaluation of postoperative risk of ventilator-associated pneumonia has some clinical value, in order to timely and effective antibiotic intervention is conducive to the rehabilitation of children.