The Dynamic Changes Levels Of Procalcitonin,Interleukin-6 And C-reactive Protein In Children With Congenital Heart Disease During The Perioperative Period

ObjectiveTo observe the dynamic changes of procalcitonin?PCT?,interleukin-6?IL-6?and C-reactive protein?CRP?in children with congenital heart disease during the perioperative period,and the relevant factors affecting the changes,to provide guidance for the postoperative management and treatment of congenital heart disease.MethodsSixty-three children with congenital heart disease?CHD?admitted to our hospital from June 2018 to August 2018 were enrolled,all these children had undergone open-heart surgery assisted by extracorporeal circulation.Peripheral blood samples were collected from 63 patients at pre-operative evaluation?T0?and at first day?T1?,second day?T2?,third day?T3?and 7th day?T4?after operation,and the serum PCT,IL-6 and CRP levels were measured.Clinical indexes such as hospitalization time,length of stay in the intensive care unit,type of congenital heart disease and operation duration were also recorded.Results1.There were 63 children with Cardiopulmonary bypass?CPB?assisted correction of congenital heart disease,including 32 males and 31 females.The median age was 6.57?2.67,16?months.Hospitalization days ranged from 7 to 35 days,with an average?17.5±7.3?days.2.The serum levels of PCT and IL-6 increased after cardiac operation and reached the peak at the first postoperative day and then slowly decreased to the normal levels at the 7th postoperative day.The CRP levels peaked at the second postoperative day and slowly decreased to the normal levels.3.The serum PCT level of>1-year-old children on the 1^st,2^nd,and 3^rd day after surgery was significantly lower than that of?1 year-old children?Z values were 2.84,2.30,3.78,P<0.05?;Studies on different levels of N-Terminal B-type natriuretic peptide?NT-ProBNP?showed that the serum PCT level of children with NT-ProBNP>125pg/mL on the 1^st,2^nd,and 3^rd day after surgery was higher than NT-ProBNP125pg/mL children?Z values are 1.81 3.48 1.80,P<0.05?;In different groups of congenital heart disease surgery,children with complicated congenital heart disease had higher serum PCT levels on the 1^st,2^nd,and 3^rd day after surgery than those with simple heart disease,the difference was statistically significant?P<0.05?.however,no significant of the CRP levels and the IL-6 levels was found in the above different groups?P>0.05?.4.The peak levels of PCT was related to the operation time?r=0.411,P=0.001?,and there was also a correlation between the PCT levels at the 2^nd,3^rd,and 7^th day after the operation and the operation time?r were 0.277,0.286,0.259,P<0.05?,all of which were statistically significant.There was no correlation between levels of the IL-6 and CRP and the operation time at each time point after operation,and there was no statistical significance?P>0.05?.ConclusionThe serum levels of PCT and IL-6 increased after cardiac operation and reached the peak at the first postoperative day and then slowly decreased to the normal levels at the 7th postoperative day.The CRP levels peaked at the second postoperative day and slowly decreased to the normal levels.Age,cardiac function and surgical complexity are all the factors that influence the serum PCT levels after cardiac operation assisted by cardiopulmonary bypass.Age,cardiac function and surgical complexity are all the factors that influence the serum PCT level after cardiac operation assisted by cardiopulmonary bypass.