肌钙蛋白Ⅰ对胆道闭锁患儿亲属活体肝移植后急性肺损伤的预测价值

Prognostic value of serum cardiac troponin I in acute lung injury after living-donor liver transplantation for children with biliary atresia

【摘要】目的评价胆道闭锁患儿亲属活体肝移植术中心肌肌钙蛋白I（cTnI）水平对术后急性肺损伤发生的预测价值。方法回顾性分析了2011年2月至2015年9月因胆道闭锁接受亲属活体肝移植112例儿童受者的临床资料，其中55例为高cTnI组（≥0．07μg／L）受者，57例为正常cTnI组（〈0．07μg／L）受者。比较两组患儿一般资料，采用单因素及多因素logistic回归法分析订nI对术后急性肺损伤发生的相关性。结果高cTnI组急性肺损伤发生率为31．6M，而正常cTnI组发生率为9．1％。术中cTnI值≥0．07μg／L（OR=4．489，95％可信区间1．170～17．226）是胆道闭锁患儿亲属活体肝移植后早期急性肺损伤发生的高危风险因素，而术前进行儿童终末期肝病模型（PELD）评分（OR=1．129，95％可信区间1．042～1．222）与术中cTnI升高存在显著相关性。结论术中cTnI升高可作为胆道闭锁患儿亲属活体肝移植后急性肺损伤发生的重要预测因子，其值与术前PELD评分存在正相关性。

Objective To evaluate the impact of cardiac troponin I （cTnI） on acute lung injury in pediatric living donor liver transplant children with biliary atresia. Methods The clinical data of 112 pediatric living donor liver transplant recipients with biliary atresia in Tianjin First Central Hospital from February 2011 to September 2015 were retrospectively reviewed. Fifty-five recipients with cTnI ≥0. 07μg/L served as high-cTnI group and 57 recipients with cTnI group 〈0. 07 μg/L as normal- cTnI group. The clinical data between two groups were compared and the association between serum cTnI level and acute lung injury after living-donor liver transplantation was evaluated by logistic regression analysis. Results The percentage of acute lung injury after pediatric living donor liver transplantation in high-eTnI group and normal-cTnI group was 31.6% and 9. 1%, respectively. Intratransplant cTnI 90, 07 gg/L （OR = 4. 489, confidence interval 1. 170-17. 226） was the risk factor for acute lung injury after transplantation. The value of cTnI showed the positive correlation with preoperative PELD scores （ OR = 4. 489, confidence interval 1. 170-17. 226 ）. Conclusions Intratransplant cTnI level was the significant prognostic risk factor in acute lung injury after pediatric living-donor liver transplantation for children with biliary atresia. The cTnI level was associated with preoperative PELD scores.