| 90 | 2 | 25 |
| 下载次数 | 被引频次 | 阅读次数 |
为了探讨通过结合C反应蛋白(C-reactive protein, CRP)、白细胞(leukocyte, WBC)和降钙素原(procalcitonin, PCT)来预测大批心脏病手术患者术后感染的可行性,本研究病例对照研究涉及423例接受心肺心脏搭桥手术的心脏病患者。基于在术后期间是否有严重的败血症或化脓性休克,病人被分成两组。在重症监护病房的第1天,提取用于生物测量(PCT, CRP和WBC)的血液样本,然后每天早上提取1次,直到术后第10天。研究发现,两组群体的CRP中值类似。在10 d术后期间,感染病人群体中的WBC和PCT中值明显比未感染的群体高。高程截止≤3次(概率:4.058, 95%置信区间:2.206～7.463; p=0.001)和高程截止≥4次(概率:10.274, 95%置信区间:3.690～28.604; p<0.001),在术后第2天,随着感染的发展,PCT中值(1.7 ng/mL)和/或WBC中值(13 000个细胞/mm3)发生了明显的变化。本研究初步表明,在术后前3 d,PCT和WBC水平结合,能够预测接下来30 d心脏手术的术后感染情况,具有一定的临床应用价值。
Abstract：In order to explore the feasibility of predicting postoperative infection in large number of heart surgery patients by combining C-reactive protein(CRP), leukocyte(WBC) and Procalcitonin(PCT), the case-control study of this study involved 423 patients with heart disease undergoing cardiopulmonary bypass surgery. The patients were divided into two groups based on whether they had severe sepsis or were septic shock during the postoperative period. On the first day in the intensive care unit, blood samples were extracted for biological measurements(PCT,CRP and WBC) and were extracted once every morning until the 10 thday after surgery. It was found that the CRP median of the two groups was similar. During the 10-days postoperative period, the WBC and PCT medians in the infected patients were significantlyhigher than those in the uninfected patients. Elevation cut-off ≤3 times(probability:4.058, 95% confidence interval: 2.206～7.463; p=0.001) and elevation cutoff ≥4 times(probability: 10.274, 95%confidence interval: 3.690～28.604; p<0.001). On the 2 ndday after the operation, with the development of infection,the PCT median(1.7 ng/mL) and/or WBC median(13 000 cells/mm3) had undergone significant changes. Our study preliminarily showed that the combination of PCT and WBC levels in the first 3 days after operation could effectively predict postoperative infection of cardiac surgery in the next 30 days and would have certain clinical application value.
Alomari Y.M.,Abd ullah S.N.H.S.,Azma R.Z.,and Omar K.,2014,Automatic detection and quantification of WBCs and RBCs using iterative structured circle detection algorithm,Comput.Math.Methods Med.,(2):979302
Boudrahem-Addour N.,Izem-Meziane M.,Bouguerra K.,Nadjem N.,Zidani N.,Belhani M.,and Djerdjouri B.,2015,Oxidative status and plasma lipid profile in beta-thalassemia patients,Hemoglobin,39(1):36-41
Chen W.Y.,Zhang B.,Mahony T.,Gu W.Y.,Rolfe B.,and Xu Z.P.,2016,Efficient and durable vaccine against intiminβof diarrheagenic E.coli induced by clay nanoparticles,Small,12(12):1627-1639
Dharmendrasinh G.A.,and Pipalia D.,2016,Design an algorithm to detect and count small size object using digital image processing,International Journal of Advanced Research in Electrical,Electronics and Instrumentation Engineering,5(5):3807-3812
Gu Z.,Atherton J.J.,and Xu Z.P.,2015a,Hierarchical layered double hydroxide nanocomposites:structure,synthesis and applications,Chemical Communications,51(15):3024-3036
Gu Z.,Wu A.H.,Li L.,and Xu Z.P.,2014,Influence of hydrothermal treatment on physicochemical properties and drug release of anti-inflammatory drugs of intercalated layered double hydroxide nanoparticles,Pharmaceutics,6(2):235-248
Gu Z.,Zuo H.L.,Li L.,Wu A.H.,and Xu Z.P.,2015b,Pre-coating layered double hydroxide nanoparticles with albumin to improve colloidal stability and cellular uptake,Journal of Materials Chemistry B,3(16):3331-3339
Gu Z.,Zuo H.L.,Wu A.H.,and Xu Z.P.,2015c,Stabilization of layered double hydroxide nanoparticles by bovine serum albumin pre-coating for drug/gene delivery,Journal of Control Release,213:e150-e151
Kamiya H.,Tanzeem N.,Akhyari P.,Pedraza A.,Kallenbach K.,Lichtenberg A.,and Karck M.,2014,Impact of severe postoperative complications after cardiac surgery on mortality in patients aged over 80 years,Ann.Thorac.Cardiovasc.Surg.,20(5):383-389
Li L.,Gu W.Y.,Liu J.,Yan S.Y.,and Xu Z.P.,2015,Amine-functionalized Si O2nanodot-coated layered double hydroxide nanocomposites for enhanced gene delivery,Nanoscale Research,8(2):682-694
Pavlovski D.,Thundyil J.,Monk P.N.,Wetsel R.A.,Taylor S.M.,and Woodruff T.M.,2012,Generation of complement component C5a by ischemic neurons promotes neuronal apoptosis,Faseb Journal,26(9):3680-3690
Pornprasert S.,and Phanthong S.,2013,Anemia in patients with coinherited thalassemia and glucose-6-phosphate dehydrogenase deficiency,Hemoglobin,37(6):536-543
Tomari R.,Zakaria W.N.W.,Ngadengon R.,and Wahab M.H.A.,2015,Red blood cell counting analysis by considering an overlapping constraint,ARPN Journal of Engineering and Applied Sciences,10(3):1413-1420
Zhang X.,Zhao H.,Li X.,Feng Y.,and Li H.,2016,A multi-scale 3D otsu thresholding algorithm for medical image segmentation,Digital Signal Processing,60:186-199
基本信息:
DOI：10.13417/j.gab.038.000945
中图分类号:R654.2
引用信息:
[1]宋世卿,黄毅.用降钙素原和白细胞联合能预测心脏手术病人的感染[J].基因组学与应用生物学,2019,38(02):945-952.DOI:10.13417/j.gab.038.000945.
2019-02-25
2019-02-25