Clinical Significance Of Platelets And Eosinophils’ Changes In Diagnosis Of Congenital Heart Disease After Transcatheter Therapy

Objective：To evaluate the count of platelets and eosinophils in patients with congenitalheart disease（CHD, atrial septal defect ASD,ventricular septal defect VSD,and patentductus arteriosus PDA）in initiation of and post transcatheter therapy，and to explorethe regularity of platelets and eosinophils count to providedclues to improve theprognosis and treatment of the patients with CHD.Methods：Patients with CHD by Ultrasonic Doppler Technology were collected andanalyzed between September2011and December2012from the second affiliatedhospital of Nan chang University.A total of94male patients and89female patientswere included in our study. Age ranged from1.5to63years(17.3±17.6years ofold).Meanwhile,109patients were less than14years and74≥14years. Among allpatients,73were diagnosed with VSD,63withASD and47with PDA. All patientswere conducted transcatheter therapy according to congenital heart disease diagnosisand treatment guidelines. We collected blood sample to detect platelets and eosinophilcount in initiation of transcatheter therapySPSS was used to explore the regularity ofplatelets and eosinophil count and related factors.Results:①A total of183patients with CHD were conducted interventional treatmentsuccessfully. Two patients with VSD developed hemolysis post transcatheter therapyand recovered with medicine therapy subsequently.②Platelet count reducedsignificantly post operation compared with pre-operation (229.10±86.71×109/Lvs.261.56±93.76, P<0.01).Postoperative platelet count with a normal range was lowerthan that pre-operation. Two patients who had residual shunt after transcatheterclosure of ventricular septal defect (TCVSD) developed severe thrombocytopenia(<50×109/L or lower than50%reduction) with hemolysis. Due to the very lowincidence, it was difficult to perform statistical analysis.③The platelet count postoperation reduced significantly compared with that pre-operation in3CHD (P＜ 0.05).There was significant difference among the3types of CHD（P＜0.05）.Plateletcount decreased significantly in VSD postoperation.④Reduction of platelet count(preoperative or postoperative) was positively related to the heparin dosage perkilogram of body weight (r=0.391, P=0.002)(the more dosage of heparin waspositively related to platelet count）and was negative related to age (r=-0.212，P=0.044). Reduction of platelet count (preoperative or postoperative) was notpositively related to the size of the occluder after operation within12hours(r=-0.127，P=0.086), and was significantly associated after operation12hours(r=0.526,p＜0.001).⑤The percentage of eosinophil post operation(0.74±1.3) waslower than that pre-operation (2.88±2.8)(P <0.01). Reduction of eosinophilproportion was positively correlated with the heparin dosage per kilogram of bodyweight (r=0.271，P=0.000).Reduction of the platelet count had no statisticallysignificant between male(27.0±38.9）and femal（38.2±52.6, P=0.125）.⑥There wasno sex and types of CHD difference of eosinophil(P>0.05).Conclusions：1、Platelet count and eosinophil percentage post transcatheter therapy decreasedsignificantly compared with pre-operation, and had no sex difference; Platelet countpost operation reduced significantly compared with that in initiation of operation in3types of congenital heart disease. In addition, platelet count decreased significantly inVSD postoperation.2、Reduction of platelet count was positively correlated with heparin dosageper kilogram of body weight, and was negatively correlated with age and was notpositively related to the size of the occlude after operation（within12hours）and wassignificantly associated after first and second day post operation. Reduction ofeosinophil increased with heparin dosage per kilogram of body weight.3、Postoperative thrombocytopenia and reduction of eosinophil percentagerecovered spontaneously without special treatment. Special attention should be paidin these patients due to severe complication may be occur. Extensive therapy waspreformed in2patients with severe thrombocytopenia after transcatheter therapy,including suspending aspirin, administration of dexamethasone to immunologicalsuppression and sodium bicarbonate to alkalinize urine, and other treatment. Renal function, blood coagulation, coagulation index, and the urine color were closelymonitored in these patients.Blood and urine test should be detected repeatedly.Platelet count and urine routine were in the normal range after10days therapy.