儿童房间隔缺损介入封堵术前后炎症反应的探讨

目的:探讨儿童房间隔缺损(ASD)封堵器植入前后炎症反应及ASD介入治疗的安全性。方法:采用酶联免疫吸附法检测19例ASD患儿介入封堵术前后血浆白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)浓度,金标法测定C反应蛋白(CRP)浓度,同时对封堵器大小、介入时间、封堵器类型、性别等各项指标进行分组,比较术前、术后即刻、术后1d、术后1个月和3个月各时间点血浆IL-6、TNF-α和CRP浓度变化。结果:与术前比较,患儿血浆IL-6、TNF-α浓度均在术后即刻升高(均P<0.05),且均于术后3个月基本恢复至术前水平;而CRP浓度无明显变化。ASD封堵器直径≥10mm与<10mm、手术时间≥60min与<60min、两个不同公司生产的封堵器和性别之间分组比较,患儿各时间点血浆IL-6、TNF-α和CRP水平均差异无统计学意义。结论:儿童ASD介入封堵术后体内出现一过性炎症反应,具有自限性。儿童ASD介入封堵治疗安全、有效。

Inflammation in children with atrial spetal defect before and after transcatheter closure

Objective:To investigate the inflammation in children with atrial septal defect(ASD) after transcatheter closure and the safety of intervention treatment.Method:Serum levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α) and C-reactive protein(CRP) were measured by enzyme linked immunosorbent assays before and after transcatheter closure,compared them before and after closure and between groups of different sizes and corporations of ASD occluder,different times of transcatheter closure and genders.Result:Compared with pre-occlusion,the contents of serum IL-6 and TNF-α increased immediately in post-occlusion(P<0.05),and gradually returned to the baseline levels at 3 months after occlusion;CRP levels didn’t chang at any time point.There were no significant differences between groups of different size(≥10 mm and <10 mm) and corporation of ASD occluder,different times of transcatheter closure(≥60 min and <60 min) and genders in levels of IL-6,TNF-α and CRP.Conclusion:Inflammation is activated in early and self-limited after transcatheter closure in children with ASD.Intervention treatment in children with ASD is safe and efficient.