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目的:探讨儿童房间隔缺损(ASD)封堵器植入前后炎症反应及ASD介入治疗的安全性。方法:采用酶联免疫吸附法检测19例ASD患儿介入封堵术前后血浆白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)浓度,金标法测定C反应蛋白(CRP)浓度,同时对封堵器大小、介入时间、封堵器类型、性别等各项指标进行分组,比较术前、术后即刻、术后1d、术后1个月和3个月各时间点血浆IL-6、TNF-α和CRP浓度变化。结果:与术前比较,患儿血浆IL-6、TNF-α浓度均在术后即刻升高(均P<0.05),且均于术后3个月基本恢复至术前水平;而CRP浓度无明显变化。ASD封堵器直径≥10mm与<10mm、手术时间≥60min与<60min、两个不同公司生产的封堵器和性别之间分组比较,患儿各时间点血浆IL-6、TNF-α和CRP水平均差异无统计学意义。结论:儿童ASD介入封堵术后体内出现一过性炎症反应,具有自限性。儿童ASD介入封堵治疗安全、有效。
Objective: To explore the safety of ASD occluder before and after implantation of inflammatory response and ASD interventional therapy. Methods: The levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in 19 children with ASD were measured by enzyme-linked immunosorbent assay (ELISA) (CRP), and the occluder size, intervention time, occluder type, gender and other indicators were grouped, compared with preoperative and postoperative immediately after 1d, 1 month and 3 months after surgery Changes of plasma IL-6, TNF-α and CRP concentrations at different time points. Results: Compared with those before operation, the levels of IL-6 and TNF-α in plasma increased immediately after operation in both groups (all P <0.05), and all returned to the preoperative levels 3 months after operation. The levels of CRP No significant changes. ASD occluder diameter ≥ 10mm and <10mm, operation time ≥ 60min and <60min, two different companies produced occluder and gender groups between groups at different time points plasma IL-6, TNF-α and CRP No significant difference in the level of water. Conclusion: There is a self-limiting inflammatory reaction in children with ASD after transcatheter closure. ASD interventional closure in children is safe and effective.