CD64在先天性心脏病围术期肺部感染患儿中的水平变化

Changes of CD64 Level in Children with Pulmonary Infection During Perioperative Period of Congenital Heart Disease

目的:探讨CD64在先天性心脏病围术期并发肺部感染患儿中的水平变化,明确其诊断价值。方法:选取2018年4-12月在本院接受手术治疗的90例先天性心脏病患儿,根据实验室检查结果、胸部X线片及临床诊断,将其分为肺部感染组(n=35)与肺部未感染组(n=55)。比较两组体外循环时间、机械通气时间;比较两组治疗前后的CD64指数、C反应蛋白(CRP)、白细胞计数(WBC);分析CD64指数与CRP、WBC的相关性。结果:两组体外循环时间比较,差异无统计学意义(P>0.05),感染组机械通气时间明显长于未感染组(P<0.05);治疗前,感染组CD64指数、WBC及CPR水平均高于未感染组(P<0.05),经过积极治疗,感染组CD64指数、WBC及CPR水平均较治疗前下降(P<0.05),且两组上述各指标比较,差异均无统计学意义(P>0.05);Pearson相关性分析显示CD64指数均与WBC、CRP呈正相关(P<0.01)。结论:在先心病患儿围术期,CD64指数与其他炎症指标表达一致,可作为对围术期肺部感染诊断的重要指标,帮助指导抗生素的合理使用,应用价值高。

Objective:To investigate the level changes of CD64 in children with congenital heart disease complicated with pulmonary infection during perioperative period,and to determine its diagnostic value.Method:A total of 90 children with congenital heart disease who received surgical treatment in our hospital from April to December 2018 were selected,according to the results of laboratory examination,chest X-ray and clinical diagnosis,the patients were divided into pulmonary infection group(n=35)and non infection group(n=55).The cardiopulmonary bypass time and mechanical ventilation time were compared between the two groups,the CD64 index,C-reactive protein(CRP)and leukocyte count(WBC)before and after treatment were compared between the two groups,and the correlation between the CD64 index,CRP and WBC was analyzed.Result:There was no significant difference in cardiopulmonary bypass time between the two groups(P>0.05),the mechanical ventilation time in the infection group was significantly longer than that in the non infection group(P<0.05).Before treatment,the CD64 index,WBC and CPR levels in the infection group were higher than those in the non infection group(P<0.05),after active treatment,the levels of CD64,WBC and CPR in the infection group were lower than those of before treatment(P<0.05),and there was no significant difference between the two groups above indexes(P>0.05).The correlation analysis of Pearson showed that CD64 index were positively correlated with WBC and CRP(P<0.01).Conclusion:The CD64 index is consistent with other inflammatory indexes in the perioperative period of children with congenital heart disease.It can be used as an important index for the diagnosis of pulmonary infection in the perioperative period,to help guide the rational use of antibiotics,and has high application value.