To Investigate The Predictive Value Of The CPP Method In The Early Diagnosis Of Pulmonary Infection After Off-Pump Coronary Artery Bypass Grafting

Backgroud:Pulmonary infection, the post-surgical complication of off-pump coronary artery bypass grafting(CABG),has an unfavorable influence on rehabilitation, and compled with bacterial resistance, the clinical antibiotic remains a challenge. Despite the successful implementation of diagnostic biomarkers in different fields of medicine,for example, D-dimers in pulmonary embolism, natriuretic peptides in acute heart failure, accurate biomarker for bacterial infection, especially pulmonary bacterial infections have been lacking. This study aims to investigate the possible way to predictive in the pulmonary infection after off-pump coronary artery bypass graftingObjectives: Study the changes of conventional bio markers, such as CRP、PCT and the new inflammatory cells of platelet with its parameter PLC, record the dynamic variations characters of CRP、PLC、PCT(abbreviation of CPP) in the pre-and-postoperative stages, and tends to investigate the predictive value of CPP method in the early diagnosis of pulmonary infection after off-pump coronary artery bypass grafting.Methods: Select the patients who underwent off-pump coronary artery bypass grafting in Anyang Peoples’s Hospital from July2013to March2014,set up select standard and resort standard,record everyone’s age, sex, weight, smoking history, drinking history, the count of coronary artery stenosis, operation time, the count of by-pass coronary, the ventilator-assisted breathing time after CABG, the bleeding amount, the transfusion amount, the number of days in ICU, the number of days in general ward,temperature, chest sign, X-ray and the results of sputum culture(the basis of grouping),detect the CRP、 PLC、PCT level in the arterial collections from the patient on the time of preoperative and postoperative one hour, after12hours, after24hours, after48hours, after72hours, then do some statistic with them.Results:37patients were included,27male vs10female, the mean age of (62.14±9.68)years, there are5cases of infection,3lcases of non-infection, infection rates of15.9%,1deaths. The operation-time,lung function and diabetes mellitus have big difference between two groups (P=0.023,0.001,0.001, P<0.05). For CRP, its amount rise quickly in the first24hours in both groups.((168.59±10.18)mg/L) in postoperative48h, and the non-infection group has a highest degree((168.59±10.18)mg/L)) in the postoperative48h, then decrease,but the infected group still has increase trend.The PLC in the infection group has a small decrease ((0.20±0.07)%)in postoperative1h, reached the top(0.21±0.08)%) in the postoperative24h,and then decline in the following time,however, the non-infection group begin to increase in the postoperative lh,reach the top ((0.19±0.04)%) in the postoperative12h,then decrease at a low level.For PCT,both the infection and the non-infection group have a high increase speed in the first12h,then has a lower increase speed, and the non-infective group begins to decline in the postoperative48h((0.29±0.26) ng/ml) while the infection group still has a high level.The differences between the three biomarkers are not the same (P<0.05)Conclusions:1. If the CRP of the patient after OPCABG keep above228mg/L in the postoperative48h and the postoperative72h,PLC has a variable tend of reverse-N phenomenon,and PCT rised to0.30ng/ml in the postoperative48h,keep arising tend in the following times, it’s possible to be pulmonary infection,so the CPP method could be used as significant serological marker to predict the pulmonary infection after OPCABG.2.The possibility of pulmonary infection after OPCABG has some relationship with the operation-time,lung function and diabetes melitus.