肺炎患者测定超敏C反应蛋白的临床价值

目的探讨血清超敏C反应蛋白（hs-CRP）水平与肺炎患者病情严重程度的相关性及其临床价值。方法选择重症肺炎患者30例作为A组,非重症肺炎患者42例作为B组,急诊科急性上呼吸道感染患者37例作为C组。对A、B组分别在初期、中期、恢复期测定血清超敏C反应蛋白、白细胞总数（WBC）、中性粒细胞比例（N%）水平,对C组在就诊时测定血清超敏C反应蛋白、白细胞总数（WBC）、中性粒细胞比例（N%）水平。并对A、B组在初期及恢复期行胸部CT或X线片检查以验证病情的严重程度及转归。结果 A、B组患者初期血清C反应蛋白水平明显上升,中期超敏C反应蛋白逐渐下降,恢复期降至正常或接近于正常;且A、B组初期血清超敏C反应蛋白水平明显高于C组（P〈0.01）;A组血清超敏C反应蛋白水平显著高于B组（P〈0.01）。结论超敏C反应蛋白可作为反映肺炎患者感染程度及病情转归的较敏感指标,在一定程度上优于白细胞总数及中性粒细胞比例。

The clinical value of measuring high-sensitivity C-reactive protein in patients with pneumonia

Objective To investigate the relationship between serum hs-CRP levels and severity of pneumonia,and discuss the clinical value.Methods 30 patients with severe pneumonia in group A,42 patients with non-severe pneumonia in group B,and 37 patients with acute upper respire tract infection in group C.Hs-CRP,WBC and N% were determined in group A and B at early,middle and recovery stage.When visiting a doctor,Hs-CRP,WBC and N% were tested in group C.Chest CT and chest X-ray were underwent in group A and B to prove severity and prognosis.Results Serum hs-CRP levels of group A and B were increased obviously at the early stage,decreased at the middle stage,fallen to normal or close to normal in the recovery stage.However,serum hs-CRP levels of group A and B at the early stage were significantly higher than group C＇s（P0.001）,serum hs-CRP levels of group A were higher than group B＇s（P0.01）.Conclusion Hs-CRP could be a sensitive index to reflect the severity of the infection and prognosis in patients with pneumonia.At certain extent,it was superior to WBC and N%.