脑梗死病人血清C-反应蛋白动态变化及临床意义

目的观察脑梗死病人血清C-反应蛋白动态变化及临床意义.方法应用免疫速率散射比浊法动态测定70例急性脑梗死病人血清C-反应蛋白值,并与22例健康人血清C-反应蛋白值比较,同时观察脑梗死病人病情轻重程度、病程、生存与死亡、病灶范围大小与血清C-反应蛋白变化的关系.结果①脑梗死组血清C-反应蛋白值与对照组血清C-反应蛋白值相比有统计学意义(P＜0.001);②脑梗死病人神经功能缺损中度组病人与轻度组病人、重度组病人与中度组病人血清C-反应蛋白值相比有统计学意义(P＜0.01);③C-反应蛋白值随脑梗死病人得病后时间的延长而逐渐减低;④脑梗死病人中生存组与死亡组C-反应蛋白值相比有统计学意义(P＜0.01);⑤脑梗死组C-反应蛋白值变化与脑梗死范围大小呈正相关(γ＝0.319,P＜0.01).结论脑梗死病人血清C-反应蛋白值在发病的不同时期呈现不同的变化,并随脑梗死病人病情轻重、梗死范围不同而变化,动态测定脑梗死病人血清C-反应蛋白值的临床意义,可作为判断脑梗死病人病情轻重,估计预后,反映病情转归和间接反映病灶范围大小的指标.     

超敏C-反应蛋白和C-反应蛋白的测定对SARS的诊断价值

目的　研究血清超敏C -反应蛋白 (hs -CRP )和C -反应蛋白 (CRP)对严重急性呼吸综合征 (SARS)的诊断价值。方法　SARS病人 2 0例、细菌性肺炎病人 2 0例、健康对照 2 0例 ,血清hs -CRP和CRP采用胶乳免疫比浊法全自动定量测定。结果　hs -CRP和CRP测定结果分别为 :健康对照组 (0 6 9± 0 6 2 )mg/L和 (4 4± 0 9)mg/L、细菌性肺炎组 (10 79± 1 36 )mg/L和 (98 0± 2 8 9)mg/L、SARS组 (3 16± 3 72 )mg/L和 (11 0± 9 6 )mg/L。三组间差异均有显著意义 (P <0 0 1)。结论　SARS病人和细菌性肺炎病人早期血清hs -CRP和CRP均升高 ,但细菌性肺炎病人升高更加显著 ,比SARS组分别增加 2 4倍和 7 9倍 ,对SARS与细菌性性肺炎的鉴别诊断有重要意义     

C-反应蛋白与冠心病

动脉粥样硬化过程中炎症反应学说近来研究颇热,作为一种炎性因子的C-反应蛋白可用于判定冠心病的预后.     

低剂量辛伐他汀对冠心病患者血脂及C-反应蛋白的影响

将104例冠心病患者随机分为治疗组（56例）和对照组（48例）,常规治疗的基础上治疗组口服辛伐他汀（理舒达10mg／d）,对照组不加降脂药物;疗程均为6个月。结果疗程结束后治疗组血脂指标及C-反应蛋白（CRP）改善情况均明显优于对照组,P均〈0．05。证实辛伐他汀对冠心病患者降脂疗效确切,所用剂量较小,且能有效降低患者的CRP,安全性良好。     

青壮年血脂和血压干预对C-反应蛋白及颈动脉粥样硬化的影响

目的探讨青壮年高血压、高血脂干预对血浆超敏C-反应蛋白（hs-CRP）、颈动脉粥样硬化的影响。方法选取符合WHO诊断标准高血压、高血脂并经彩色多普勒明确颈动脉粥样硬化患者21例（治疗组）,另选同期健康志愿者15例（对照组）,治疗组给予ARB、ACEI、他汀类药物等控制血压、血脂达标,hs-CRP检测及相关诊疗,12个月后复查测定颈动脉内膜-中层厚度（IMT）、颈动脉粥样斑块面积、颈动脉内径以及hs-CRP。结果治疗前治疗组患者与对照组hs-CRP浓度间差异有显著性意义（P＜0．05）,治疗后与对照组间差异无显著性意义（P＞0．05）。治疗组患者治疗前、后颈动脉斑块面积、IMT、血管内径间差异均有显著性意义（P＜0．05）;治疗组患者治疗后IMT与对照组间差异有显著性意义（P＜0．05）,血管内径与对照组间差异无显著性意义（P＞0．05）。结论对青壮年血脂、血压进行干预,可使血清hs-cRP水平下降、颈动脉粥样硬化减轻。     

心绞痛患者C-反应蛋白的观察

越来越多证据表明 ,局部或全身炎症在动脉粥样硬化(AS)发生、发展及并发症的产生中起着重要作用。作者观察了 C-反应蛋白 (CRP)在稳定型心绞痛 (SAP)和不稳定型心绞痛 (U AP)患者中的变化。1　对象和方法1.1　对象　本院 1998- 0 7～ 2 0 0 0 - 0 8经临床心电图和 Holter诊断明确的心绞痛患者 44例 ,其中 SAP组 2 1(男 15 ,女 6 )例 ,年龄 6 2± 4岁 ,吸烟史 9± 2年 ,U AP2 3(男 17,女 6 )例 ,年龄 6 3± 3岁 ,吸烟史 10± 3年。以上患者均排除恶性肿瘤、炎症、1个月内的外科手术和严重创伤、已知的血栓性疾病、射血分数 (EF)低于…     

C-反应蛋白和动脉血栓的形成

C-反应蛋白（CRP）是反映炎症的敏感指标。近年来，许多研究发现CRP与动脉血栓的形成密切相关，它可以通过许多途径来促进动脉血栓的发生。     

高敏C-反应蛋白及其在心血管疾病中的临床意义

C反应蛋白作为一种传统的检测因子,已在临床应用多年。目前,对高敏C-反应蛋白在心血管疾病危险度预测方面又有了新的认识。现对高敏C-反应蛋白的结构及生物学特性、作用、来源及调控、变化特点及检测方法和临床上高敏C-反应蛋白在心血管疾病方面的应用等作一综述。     

C-反应蛋白与冠心病

C-反应蛋白(CRP)是系统炎症产生的急性蛋白之一，它有助于评价心血管的危险因素。高敏C-反应蛋白(hsCRP)的检测越来越受到广泛运用。     

C-反应蛋白和糖尿病

C-反应蛋白是反映炎症的敏感指标,近年的研究发现其血浆浓度水平与糖尿病及其大血管并发症的发生和发展相关,从而提出糖尿病及其大血管并发症是炎症性疾病的假说,C-反应蛋白可以预测糖尿病未来风险及评估临床治疗的实用性。     

Hepatitis C infection is associated with lower lipids and high-sensitivity C-reactive protein in HIV-infected men

Increased cardiovascular risk has been linked to HIV infection and combination antiretroviral therapy, but the impact of hepatitis C virus (HCV) status on indices of cardiovascular risk has not been routinely assessed in the HIV-infected population. The objective of this study was to analyze associations of HCV, HIV, and combination antiretroviral therapy with lipid levels and C-reactive protein (CRP) among older men. We measured fasting total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride, and high-sensitivity CRP serum levels in a cross-sectional study of 108 HIV-infected and 74 HIV-uninfected at-risk older men. One hundred ten men (60%) had detectable HCV RNA, with no difference by HIV status (p = 0.25). The majority (88%) of men with HCV infection had a history of injection drug use. Among all men, HCV infection was independently associated with lower total cholesterol (p < 0.001), LDL-C (p < 0.001), triglycerides (p = 0.01), and CRP (p = 0.001). Among HIV-infected men, HCV infection was associated with lower total cholesterol (p < 0.001), LDL-C (p < 0.001), and CRP (p = 0.004). HCV infection was associated with lower triglycerides among men on protease inhibitors (PI) (p = 0.02) and non-PI combination antiretroviral therapy (p = 0.02), but not among antiretroviral-na?ve men. These findings demonstrate an association of lower serum lipid and CRP levels with HCV infection and suggest that HCV status should be assessed as an important correlate of cardiovascular risk factors in studies of older men with or at risk for HIV.     

Serum C-reactive protein and lipids in ultra-Marathon runners

In this investigation, we compared lipid and inflammatory parameters in regular long distance runners with matched sedentary controls. Long distance runners had significantly lower low-density lipoprotein cholesterol and C-reactive protein levels than the control group. This exercise-induced reduction in low-density lipoprotein cholesterol was independent of the decrease in C-reactive protein levels.     

脂联素和超敏C反应蛋白在HIV感染者抗反转录病毒治疗中的变化

目的通过观察高效抗反转录病毒治疗(Highly active antiretroviral therapy,HAART)对心血管疾病(Cardiovascular disease,CVD)标志物脂联素(Adiponectin,APN)和超敏C反应蛋白(High-sensitivity C-reativeprotein,hs-CRP)的影响,判断与艾滋病病毒(Human immuno deficiency virus,HIV)感染、治疗相关的CVD发生、发展状况,为HIV感染者CVD的防治提供依据。方法对唐都医院127例HIV感染者和63名健康志愿者,采用酶联免疫吸附试验(Enzyme-linked immunosorbent assay,ELISA)检测APN和hs-CRP浓度,通过横向和纵向研究,观察APN和hs-CRP的变化。结果治疗组APN浓度为(3.35±3.21)μg/mL,明显低于未治疗组(6.34±6.93)μg/mL和对照组(5.34±5.44)μg/mL。hs-CRP检测结果三组之间没有差异。对治疗组36例患者进行随访,发现APN在24周前升高,在24周后逐渐降低,但是hs-CRP在随访中没有明显变化。结论在HAART中的HIV感染者,APN浓度先升后降,而hs-CRP并没有明显变化,动态监测这些指标有利于HIV感染者CVD的早期预防。     

Association of ferritin and lipids with C-reactive protein

C-reactive protein (CRP) and lipids (e.g., low-density lipoprotein [LDL]) are both markers of cardiovascular disease risk, yet they are not highly correlated. Oxidative stress of lipids induced by iron may play a role in vascular inflammation, as indicated by CRP. The purpose of this study was to examine, in a representative sample of United States adults, the relation between ferritin, lipids, and CRP. We analyzed data on adults (aged > or =25 years) in the National Health and Nutrition Examination Survey III, a national public-use data set collected between 1988 and 1994. Ferritin, total cholesterol, LDL, high-density lipoprotein, and ferritin-lipid combinations were analyzed in relation to CRP in age-, gender-, and race-adjusted models as well as models with other potential confounding variables. In adjusted models, neither elevated ferritin (odds ratio [OR] 1.11, 95% confidence interval [CI] 0.94 to 1.32) nor elevated LDL was significantly associated with elevated CRP (OR 1.03, 95% CI 0.79 to 1.33). Patients with elevated ferritin and elevated LDL were more likely to have elevated CRP (OR 1.68; 95% CI 1.06 to 2.68). Patients with elevated ferritin and low high-density lipoprotein were also more likely to have elevated CRP (OR 1.71; 95% CI 1.28 to 2.27). These results suggest that both iron and lipids induce inflammation. Future research needs to focus on preventive medicine to decrease iron in patients with elevated lipids.     

老年住院患者97例死亡病因分析及其超敏C-反应蛋白与血脂变化回顾

目的：探讨老年死亡患者一般情况和疾病分布,分析血清超敏C-反应蛋白（hs-CRP）、血脂在死因第一诊断为冠心病（CHD）的死亡患者中的变化规律。方法收集整理老年科住院死亡病例97份进行统计分析,并对死因第一诊断为CHD和非CHD患者的hs-CRP、血脂进行回顾对比分析。结果分析提示总病死率0.89%,男性病死率1.12%,女性病死率0.69%,前者高于后者（P＜0.05）;前5位死亡疾病是：急性心肌梗死、慢性充血性心脏病、肺部感染、心源性猝死、多个心脏瓣膜病;CHD死亡患者的总胆固醇（TC）含量高于非CHD死亡患者（P＜0.05）,hs-CRP、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）水平差异无统计学意义（P＞0.05）。结论 CHD是老年科患者死亡的最主要原因,CHD老年死亡患者的胆固醇较非CHD死亡患者高。     

High-sensitivity C-reactive protein levels fall during statin therapy in HIV-infected patients receiving ritonavir-boosted protease inhibitors

HIV-infected patients are at an increased risk of developing cardiovascular disease. Elevated levels of C-reactive protein (CRP) are associated with an increased risk of cardiovascular disease in the general population and are reduced by statin therapy. We examined the effect of pravastatin and rosuvastatin on CRP levels in 58 dyslipidemic HIV-infected patients. A 45-day course of either statin reduced the median CRP level from 3.0 to 2.4 mg/l (P < 0.001) with no correlation with changes in lipid parameters.     

C反应蛋白水平在COPD病人、IHD病人，吸烟者和非吸烟者中的比较研究

目的评价在COPD病人中IHD症状和吸烟对CRP升高的潜在影响，并检验糖皮质激素（ICS）药物治疗与CRP血清水平之间的联系。方法对46名COPD患者与对照组的18名吸烟者（Smoking）和20名不吸烟者（N．Smoking）进行比较。结果COPD病人的CRP血清水平[4．83±1．23mg／L]显著高于两个对照组，具有显著性差异（P〈0．05），但是CRP血清水平在两个对照组中却无统计学意义。ICS治疗后，COPD病人的CRP水平降低。结论对COPD病人使用ICS治疗能够降低CRP水平。CRP可以作为COPD患者体内组织炎症的标志物。     

C-reactive protein and fever in neutropenic patients

The predictive value of daily C-reactive protein (CRP) monitoring to distinguish causes of fever in neutropenic patients was studied retrospectively. A total of 143 fever episodes during 113 consecutive hospitalizations were studied in 71 patients who had been referred for chemotherapy or haemopoietic stem cell transplantation (HSCT). There were, on average, 1.3 fever episodes per hospital stay, attributed to: infection (55, 27 invasive bacterial, 5 fungal, 3 viral and 20 probable infections); acute graft vs host disease (GvHD) (20); drugs (22); transfusions (7); and not attributable (39). 130 (91%) fever episodes were accompanied by a rise in CRP, 6 (4%) episodes were fatal. Maximal CRP levels (CRPmax) and maximal temperature (Tmax) were higher in invasive bacterial infections than in aGvHD and higher in aGvHD than in drug- or transfusion-related fever (p < 0.0001). Temperature and CRP rose in parallel. A total of 16 patients developed grade II-IV aGvHD by day 11 (9-21) (median, range) after allogeneic HSCT. Acute GvHD was preceded by fever for 3 d (1-7), and by CRP increase for 5 d (0-15) (p < 0.0001). CRP monitoring may be useful to distinguish between causes of fever. Very high CRP levels tend to be associated with invasive bacterial infections. CRP is not an early warning sign. An increase in CRP and fever may precede other clinical manifestations of aGvHD.