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大动脉手术中的炎症:根据病理和大动脉部分的生物标志物的术后演变
Martin T Yates1, Alexander Smith1, Alina A Mistirian1
1Department of Cardiothoracic Surgery, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK.
Journal of cardiothoracic surgery
|April 17, 2024
概括
术后炎症生物标志物,如白细胞 (WBC) 和C反应蛋白 (CRP),在大动脉手术后表现出不同的趋势. 了解这些模式可以帮助减少在接受大动脉修复的患者中使用抗生素.
科学领域:
- 心血管外科心血管外科
- 炎症生物标志物 炎症生物标志物
- 大动脉病理学
背景情况:
- 大动脉病理经常会提升炎症生物标志物.
- 开放性大动脉手术涉及严重的创伤,包括缺血和心肺绕道.
- 炎症反应因大动脉疾病和手术方法而异.
研究的目的:
- 分析不同主动脉手术患者的术后炎症生物标志物趋势.
- 为了比较白细胞 (WBC) 和C反应蛋白 (CRP) 在各种大动脉病理中的趋势.
主要方法:
- 对193名接受大动脉手术的患者 (2017-2021) 的回顾性审查.
- 根据干预分组的患者:A型大动脉剖析 (AD) 修复,大动脉根置换 (ARR),大动脉 + 冰象体 (FET),以及下降胸腔/胸腔腹腔大动脉修复 (DTA/TAA).
- 在手术后15天内监测每日WBC和CRP值.
主要成果:
- 所有组在2-4天内都出现了最初的炎症峰值 (WBC 12-15 × 10^9/L).
- 在AD和FET组中,出现了类似的趋势,在第2天和第10天达到峰值.
- DTA/TAA患者表现出延长的炎症反应;AD的白血球最高,DTA/TAA的CRP最高. 在15天后,CRP仍然升高 (>100 mg/L).
结论:
- 术后炎症生物标志物的趋势因大动脉病理和手术复杂性而有所不同.
- 了解这些独特的炎症模式可以指导抗生素管理.
- 进一步的研究可能有助于减少这些患者不必要的抗生素暴露.
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