Clinical Significance Of Monitoring Hs-CRP And Serum CTnI During Perioperation Of Infant Congenital Heart Disease

Objective: To explore the clinical significance of dynamic determination of hypersensitive C-reactive protein and serum cardiac troponinI during perioperation of infant cardiopulmonary bypass(CPB) surgery.Method: 307 cases were collected from August 2009 to April 2010 ,thirty children with congenital heart disease were allocated into simple CHD group (n = 10) and mixed CHD group (n = 10)and complex CHD group(n = 10) randomly.Hs-CRP and serum cTnI were determined in 30 patients with CPB before the surgery 1h(T1)and after the surgery 1h(T2),6h(T3),24h(T4),72h(T5) and 7th day(T6) respectively.At the same time,the electrocardiogram, notropic score ,the interval duration of aorta cbstructed ,mechanical assisted ventilation,postoperative ICU custodial monitoring and hospitalization after CPB surgery were recorded.Results: Hs-CRP and serum cTnI were in normal range in every group before the surgery . After surgery the level of hs-CRP and serum cTnI rosed significantly.Hs-CRP reached its peak at postoperation 24h(P﹤0.01),and declined gradually after 72h.the level of cTnI began to increase at postoperation 1h(P﹤0.01) and returned normal after 7 th day after the surgery.There were no significant differences in these parameters in simple CHD group compared with mixed CHD group .But comparing complex CHD group with simple CHD group and mixed CHD group ,there were significant difference.Meanwhile,the level of serum cTnI has positive correlation to the time of mechanical assisted ventilation(r=0.63,P﹤0.05),the time of aorta obstructed(r=0.78,P﹤0.05);the level of hs-CRP has positive correlation to the time of postoperative ICU custodial monitoring(r=0.67,P﹤0.05).Conclusions: Hs-CRP and serum cTnI can reflect the lever of inflammatory response and the myocardial cell damage degree during perioperation of infant cardiopulmonary bypass(CPB) surgery.And there is important clinical reference value for custodial monitor and treatment after CPB surgery .