论文部分内容阅读
目的研究PDA介入治疗是否会导致心肌损伤和炎性反应,分析介入治疗致心肌损伤的影响因素。方法选取2008年10月-2010年8月在本院住院的37例PDA患儿。于术前,术后即刻,术后4 h、2 d、3 d、7 d,采集静脉血,应用ELISA法检测其血清心肌肌钙蛋白I(cTnI)和CRP水平,并记录年龄、缺损大小、曝光时间和造影剂量等相关危险因素。应用SPSS 13.0软件进行统计学处理。结果 PDA介入治疗术后即刻、4 h、2 d和3 d cTnI水平分别为0.08(0.00～1.37)μg.L-1、0.09(0.00～0.68)μg.L-1、0.06(0.00～0.96)μg.L-1及0.04(0.00～0.96)μg.L-1,较术前[0.05(0.00～0.58)μg.L-1]升高;术后7 d[0.04(0.00～0.44)μg.L-1]已低于术前水平,高峰出现在术后4 h,与术前cTnI水平比较差异有统计学意义(P<0.05);术后各时段cTnI均低于正常水平。于术后4 h CRP[0.36(0.00～28.00)mg.L-1]开始升高,至术后3 d达峰值[7.79(0.20～52.40)mg.L-1],继之下降;与术前[0.30(0.00～17.06)]相比,术后3 d及7 d CRP水平[4.10(0.20～34.57)mg.L-1]均显著升高(Pa<0.05);术后各时段CRP均低于正常水平。年龄、曝光时间、缺损大小和造影剂量等与cTnI变化无明显相关性。结论 PDA介入治疗未引起明显心肌损伤及炎性反应,是一种安全的治疗手段。
Objective To investigate if PDA intervention can cause myocardial injury and inflammatory reaction and to analyze the influencing factors of myocardial injury induced by interventional therapy. Methods Totally 37 PDA patients hospitalized in our hospital from October 2008 to August 2010 were selected. Venous blood was collected before operation, immediately after operation, 4 h, 2 d, 3 d and 7 d after operation. Serum cardiac troponin I (cTnI) and CRP levels were measured by ELISA. Age, defect size , Exposure time and contrast dose and other related risk factors. Application SPSS 13.0 software for statistical analysis. Results The levels of cTnI at 4 h, 2 d and 3 d after PDA intervention were 0.08 (0.00-1.37) μg.L-1.0.09 (0.00-0.68) μg.L-1.0.06 (0.00-0.96) (P0.05 ~ 0.006) μg.L-1, which was significantly higher than that before the operation [0.05 (0.00-0.58) μg.L-1] L-1] was lower than the preoperative level, the peak appeared at 4 h postoperatively, which was significantly different from the preoperative cTnI level (P <0.05). The cTnI of all the patients was lower than the normal level after operation. CRP [0.36 (0.00 ~ 28.00) mg.L-1] started to rise at 4 h postoperatively, reaching a peak value of 7.79 (0.20-52.40) mg.L-1 at 3 d postoperatively, followed by a decrease The levels of CRP at 4. d (0.20 ~ 34.57) mg.L-1 at 3 d and 7 d after operation were significantly higher than those at baseline [0.30 (0.00 ~ 17.06)] Below normal level Age, exposure time, defect size and contrast dose and cTnI changes no significant correlation. Conclusion PDA intervention did not cause significant myocardial injury and inflammatory response, is a safe treatment.