严重急性呼吸综合征患者血清急性时相反应蛋白的测定

目的　探讨血清中补体C3和C4、C反应蛋白 (CRP)、前白蛋白 (PA)等急性时相反应蛋白检测对严重急性呼吸综合征 (SARS)的诊断价值。方法　透射比浊法检测 5 4例临床诊断的SARS患者、2 0例其他肺炎患者和 30名健康体检者血清中C3、C4、CRP和PA的含量。结果　SARS组C3为 (1 18± 0 4 2 )g/L ,C4为 (1 15± 0 5 6 ) g/L ,CRP为 (10 5 2± 8 77)mg/L ,PA为 (10 7± 34)mg/L ;对照组C3为 (1 11± 0 5 6 )g/L ,C4为 (0 38± 0 2 6 ) g/L ,CRP为 (0 4 2± 0 2 6 )mg/L ,PA为(376± 74 )mg/L ;肺炎组C3为 (1 30± 0 4 6 ) g/L ,C4为 (0 5 7± 0 31) g/L ,CRP为 (0 88± 0 4 3)mg/L ,PA为 (2 91± 76 )mg/L。SARS患者PA明显降低 ,C4和CRP则明显升高 ,差异有显著性 ;各组C3含量比较差异无显著性。结论　检测急性时相蛋白C4、CRP和PA有助于SARS的早期鉴别诊断。

Determination of serum acute phase reaction protein in patients with severe acute respiratory syndrome

OBJECTIVE: To study the diagnostic value of determinations of serum acute phase reaction protein, such as complement 3 (C3), complement 4 (C4), prealbumin (PA) and C-reactive protein (CRP), etc., in patients with severe acute respiratory syndrome (SARS). METHODS: Serum levels of C3, C4, PA and CRP were determined by turbidimetry in 54 cases of SARS, 20 of other pneumonia and 30 normal persons. RESULTS: Serum concentrations of C3, C4, CRP and PA were (1.18 +/- 0.42) g/L, (1.15 +/- 0.56) g/L, (10.52 +/- 8.77) mg/L and (107 +/- 54) mg/L in SARS patients, (1.30 +/- 0.46) g/L, (0.57 +/- 0.31) g/L, (0.88 +/- 0.43) mg/L and (291 +/- 76) mg/L in patients with other pneumonia, and (1.11 +/- 0.56) g/L, (0.38 +/- 0.26) g/L, (0.42 +/- 0.26) mg/L and (376 +/- 74) mg/L in normal persons, respectively. Serum level of PA was significantly lower and levels of C4 and CRP significantly in patients with SARS higher than those in patients with other pneumonia and normal persons (P < 0.01). There was no significant difference in serum level of C3 between the three groups (P > 0.05). CONCLUSION: Determination of serum level of C4, CRP and PA in suspected patients is beneficial to early differential diagnosis for SARS.