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目的探讨血清白细胞介素-6(IL-6)、降钙素原(PCT)、高敏C反应蛋白(hs-CRP)及慢性健康状况评分系统Ⅱ(APACHEⅡ)与导管相关性血流感染(CRBSI)心脏手术患儿预后的相关性,为临床诊治提供参考。方法选取2012年1月-2015年8月在医院行中心静脉导管置管后疑诊为CRBSI的先天性心脏病手术患儿100例,根据血培养及静脉导管尖端培养结果确诊为CRBSI者42例(CRBSI组)、非CRBSI者58例(非CRBSI组),患儿在疑诊CRBSI当日及治疗7d后抽血检测血清IL-6、PCT、hs-CRP及进行APACHEⅡ评分评估,观察7d时感染控制情况。结果疑诊当日血清IL-6、PCT、hs-CRP水平及APACHEⅡ评分,CRBSI组高于非CRBSI组(P<0.05);CRBSI组治疗7d时进行预后评估,34例感染控制,8例感染未控制,所占构成比分别为80.95%、19.05%,血清IL-6、PCT、hs-CRP水平及APACHEⅡ评分,感染控制患儿疑诊断当日、治疗7d以上指标均低于感染未控制患儿(P<0.05);Spearman相关性分析显示IL-6、PCT、hs-CRP与APACHEⅡ评分间有正相关性(P<0.05)。结论心脏病手术患儿CRBSI时血清IL-6、PCT、hs-CRP与APACHEⅡ评分明显增高,其水平高低与与患儿感染严重程度及预后关系密切。
Objective To investigate the relationship between Serum IL-6, PCT, hs-CRP, APACHEⅡ and CRBSI ) The prognosis of children with cardiac surgery, provide a reference for clinical diagnosis and treatment. Methods 100 children with congenital heart disease suspected of CRBSI after central venous catheterization in hospital from January 2012 to August 2015 were enrolled. According to the result of blood culture and intravenous catheter tip culture, 42 patients were diagnosed as CRBSI (CRBSI group) and 58 non-CRBSI patients (non-CRBSI group). Serum levels of IL-6, PCT and hs-CRP in blood were measured on the day of suspected CRBSI and 7 days after treatment, and APACHEⅡ score was evaluated. Control the situation. Results Serum levels of IL-6, PCT, hs-CRP and APACHEⅡ on the day of diagnosis were higher in CRBSI group than in non-CRBSI group (P <0.05); prognosis was assessed in CRBSI group at 7 days Control, accounting for 80.95%, 19.05%, serum IL-6, PCT, hs-CRP and APACHEⅡscores respectively. On the day of diagnosis, the indexes above 7d after treatment were lower than those in uncontrolled children P <0.05). Spearman correlation analysis showed a positive correlation between IL-6, PCT, hs-CRP and APACHEⅡscore (P <0.05). Conclusion Serum levels of IL-6, PCT, hs-CRP and APACHEⅡ in CRBSI patients are significantly higher than those in children with heart disease. The levels of IL-6, PCT, hs-CRP and APACHEⅡ are closely related to the severity and prognosis of children with CRBSI.