心脏术后体外膜肺氧合支持患者的呼吸道感染现状及其对机体免疫功能的影响

doi:10.3969/j.issn.1671-7171.2018.06.026

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Abstract 【Objective】To investigate the status of respiratory tract infection in patients with extracorporeal membrane oxygenation (ECMO) after cardiac surgery and its effect on immune function.【Methods】From March 2016 to February 2018, 32 patients with respiratory tract infection positive for sputum culture were selected and treated with ECMO support. The pathogenic results of sputum culture in patients with respiratory tract infection were analyzed. The levels of immunoglobulin(IgA、IgM、IgG), T cell subsets (CD3⁺, CD4⁺, CD8⁺), plasma atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP) and N-terminal B-type brain natriuretic peptide precursor (NT-proBNP)were compared before treatment and 12 h ,24h and 36 h after treatment.【Results】 A total of 32 strains of pathogens was isolated, of which 21 were gram-negative bacilli (65.63%), 7 were gram-positive cocci (21.88%), 4 were fungi (12.50%). 12 hours, 24 hours and 36 hours after treatment, the serum levels of IgA, IgM and IgG were lower than those before treatment, and the level of IgA, IgM and IgG decreased to the lowest point at 12 hours after treatment, and then gradually increased, but still significantly lower than before the treatment, the difference was statistically significant (P<0.05). 12 hours and 24 hours and 36 hours after treatment, the levels of CD3⁺, CD4⁺ and CD8⁺ in the patients were all decreased compared with those before treatment. 12 hours of treatment, the levels of CD3⁺ CD4⁺ and CD 8⁺ decreased to the lowest point, and then gradually increased, but still significantly lower than those before treatment. The difference was statistically significant (P<0.05). The plasma levels of ANPBNPNT-proBN in the patients decreased to the lowest level 12 hours after treatment, and gradually increased after 12 hours of treatment, but still significantly lower than those before treatment, and the levels of ANP,BNP,NT-proBN in plasma decreased to the lowest level 12 hours after treatment, but were still significantly lower than those before treatment, the difference was statistically significant (P<0.05).【Conclusion】 The incidence of respiratory tract infection in patients with extracorporeal membrane oxygenation support after cardiac surgery is high. It can inhibit the immune function and plasma ANP、BNP and NT-proBNP level of patients.

Key words： CardiacSurgicalProcedures ExtracorporealMembraneOxygenation RespiratoryTractInfections Immunoassay

Received: 25 May 2018

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R654.2

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http://www.jcr.net.cn/EN/10.3969/j.issn.1671-7171.2018.06.026 OR http://www.jcr.net.cn/EN/Y2018/V35/I6/1120

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