C-反应蛋白和血清降钙素原对危重患者感染的监测价值研究

目的探讨C-反应蛋白（CRP）和血清降钙素原（PCT）对危重患者感染的监测价值。方法收集2012年10月至2013年10月本院ICU病房收治的98例危重患者,根据辅助检查结果将其分为细菌感染组（68例）和病毒感染组（30例）两组,对其PCT和CRP含量进行测定。并将细菌感染组患者随机分为观察组和对照组,每组各34例;动态监测其治疗前后PCT和CRP含量的变化情况。结果细菌感染组和病毒感染组患者的PCT平均含量分别为（3.64±0.58）μg/L和（0.37±0.35）μg/L,差异具有统计学意义（t=2.437,P〈0.05）。细菌感染组和病毒感染组患者的CRP平均含量分别为（38.27±20.55）mg/L和（37.91±20.63 mg/L）相比,差异无统计学意义（t=0.694,P〉0.05）。观察组治疗后PCT的平均含量由治疗前的（3.68±0.62）μg/L下降为（0.53±0.21）μg/L,相比于对照组由治疗前的（3.59±0.51）μg/L下降为（2.67±0.43）μg/L,下降幅度更大;观察组治疗后CRP的平均含量为（13.81±5.64）mg/L,显著低于对照组的（21.53±5.38）mg/L,差异具有统计学意义（t=5.724,P〈0.05）。结论 PCT和CRP含量的动态监测在临床应用时各有优势,二者联合应用,在对危重患者感染的诊断和治疗中具有极高的临床价值。     

联合检测降钙素原与高敏C-反应蛋白鉴别透析患者炎症原因的价值

目的 评价联合检测降钙素原与高敏C-反应蛋白鉴别透析患者炎症原因的临床价值.方法 选取本院血液净化中心门诊血液透析(hemodialysis,HD)患者.自2013年12月开始每个月化验高敏C-反应蛋白(high sensitive C-reactive protein,hs-CRP)和降钙素原(procalcitonin, PCT).以hs-CRP＞ 10 mg/L为界限,按照入选标准,结合临床诊断,收集感染性炎症组、非感染性炎症组病例.截止到2014年11月,共得到研究病例120例,其中感染性炎症62例(细菌性感染50例,病毒性感染12例,其中败血症23例),非感染性炎症58例(膜反应42例,血管炎8例,肿瘤4例,心肌梗死4例).检测感染性炎症败血症组患者在治疗期间PCT、hs-CRP水平,将所有数据进行统计学分析.结果 感染性炎症组与非感染性炎症组比较,PCT和hs-CRP差异有统计学意义(P＜0.05);细菌性感染组与病毒性感染组比较,PCT差异有统计学意义(P＜0.05),而hs-CRP差异无统计学意义;PCT诊断败血症的临界值是2.0 ng/ml,曲线下面积为0.802±0.054,此时敏感度为85.9％,特异度为91.4％.hs-CRP诊断败血症的临界值是49.3 mg/L,曲线下面积为0.736±0.013,此时敏感度为89.7％,特异度为74.1％.PCT与hs-CRP的曲线下面积比较,差异有统计学意义(P＜0.05).结论 针对透析患者,检测PCT和hs-CRP对于鉴别炎症是感染性还是非感染性都有意义,但在鉴别细菌性还是病毒性、感染的严重程度以及判断疗效上,PCT显示出更好的敏感性和特异性.所以,联合检测PCT和hs-CRP可提高透析患者炎症病因诊断的可靠性,在临床上有很高的应用价值.     

血清降钙素原、C-反应蛋白诊断外科手术后感染的临床价值

目的分析血清降钙素原(PCT)与C-反应蛋白(CRP)诊断外科手术后感染的临床价值。方法选取2017-10-2019-10间在焦作市第二人民医院接受外科手术治疗的100例非感染性疾病患者。将发生术后感染的患者作为观察组,将未发生感染的患者作为对照组,各50例。采集5 mL清晨空腹静脉血,应用酶联免疫荧光分析法测定PCT,应用免疫比独法测定CRP。比较2组的检测结果,并根据阳性评定标准比较2组检测的阳性率。结果观察组患者的PCT、CRP水平和PCT的阳性率均高于对照组,差异均有统计学意义(P<0.05)。观察组患者的CRP阳性率虽高于对照组,但差异无统计学意义(P>0.05)。结论 PCT与CRP均可作为外科手术后感染的诊断依据之一,但PCT的阳性率较CRP高。     

甲状腺激素、降钙素原和C-反应蛋白对脓毒症患者病情及预后评估的价值

目的结合脓毒症患者病情、住院病死率探讨血清甲状腺激素（TH）、血清降钙素原（PCT）和C-反应蛋白（CRP）三者对脓毒症患者预后的评估价值。 方法采用回顾性研究,根据2008年国际脓毒症定义的脓毒症诊断标准,将入选病例分为脓毒症组、严重脓毒症组（包括严重脓毒症及脓毒症休克患者）、非全身炎症反应综合征（SIRS）对照组;脓毒症、严重脓毒症组按照患者的住院病死率,分为存活组及死亡组。测定各组患者入院24 h内的TH、PCT及CRP浓度并进行各组间的统计学分析。 结果严重脓毒症患者血清FT₃、TT₃、TT₄水平显著低于脓毒症及对照组（P均< 0.05）,脓毒症患者血清FT₃、TT₃水平低于对照组（P均< 0.05）;脓毒症及严重脓毒症患者血清PCT、CRP水平显著高于对照组（P均< 0.05）,严重脓毒症患者较脓毒症患者血清PCT水平显著升高（P < 0.05）,但两组CRP水平差异无统计学意义;死亡组FT₃、TT₃、PCT水平显著高于存活组（P均< 0.05）,但CRP差异无统计学意义;各组的TSH含量变化无统计学意义。 结论CRP是鉴别SIRS和非SIRS的有效指标,但并非早期诊断脓毒症的可靠指标。PCT、TH是早期诊断脓毒症并能与非SIRS鉴别的特异性较高的炎症指标;结合PCT和TH水平可以客观判断脓毒症病情的严重性。同时,TH与PCT水平与脓毒症预后显著相关,两者联合应用有望成为早期判断脓毒症预后的快速、可靠且非有创性指标。     

降钙素原和C-反应蛋白水平及白细胞计数联合检测对呼吸道感染的诊断价值

目的探讨血浆降钙素原（PCT）、C-反应蛋白（CRP）水平及白细胞（WBC）计数联合检测在呼吸道感染诊断中的临床意义。 方法选取2013年7月至2014年4月于本院就诊的呼吸道感染者共104例,按照是否伴有细菌感染分组,选取同期健康体检者40例作为对照组,比较两组研究对象血浆PCT、CRP水平和WBC计数的差异,计算各指标联合检测对呼吸道细菌感染的诊断效率。 结果细菌感染组患者血浆PCT、CRP水平和WBC计数较非细菌感染组患者均显著升高,差异具有统计学意义（t = 9.316、8.389、8.495,P均= 0.000）;三者联合检测的敏感度与PCT、CRP、WBC检测差异均具有统计学意义（χ² = 30.687、21.682、22.753,P均= 0.000）,联合检测的特异度与CRP、WBC检测差异均具有统计学意义（χ² = 11.665、11.665,P均= 0.000）。 结论PCT、CRP水平和WBC计数联合检测能够有效地提高临床对于呼吸道感染的诊断率,同时有利于对细菌性感染的准确判定,亦为临床合理用药提供了一定的依据。     

降钙素原在严重细菌感染诊断中的应用价值

严重细菌感染时,感染者体内的降钙素原（PCT）明显升高。2006--2007年,笔者对严重细菌感染患者的血清PCT进行检测,并与同期C．反应蛋白（CRP）、结合珠蛋白（HP）、铜蓝蛋白（CER）、α1-酸性糖蛋白（α1-AG）、α1-抗胰蛋白酶（α1-AT）、WBC及红细胞沉降率（ESR）比较,旨在探讨PCT对严重细菌感染的诊断价值。     

重症急性胰腺炎患者血清降钙素原及C-反应蛋白变化研究

目的研究重症急性胰腺炎患者C-反应蛋白(CRP)及血清降钙素原(PCT)变化,为临床相关诊治提供参考。方法选取我院于2016年8月至2018年5月期间收治的90例重症急性胰腺炎作为观察对象(SAP组),另选取同期收治的90例轻症急性胰腺炎组(MAP组)和100例来院参加体检的健康体检者(对照组)。对比检测三组患者的CRP及PCT变化,并分析二者联合诊断价值。结果三组受检患者相比,SAP组患者血清CRP、PCT水平高于MAP组,且MAP组高于对照组,差异均有统计学意义(P0.05)。血清PCT诊断的ROC曲线下降面积为0.87,最佳节点为≥3ng/mL;血清CRP诊断的ROC曲线下降面积为0.79,最佳节点为≥50mg/L。二者联合诊断的阴性似然比为0.14、阳性似然比为4.14、准确度为88.2%、特异度为86.4%、敏感度为91.5%。结论重症急性胰腺炎患者C-反应蛋白及血清降钙素原与病情发展呈正相关,且两项指标联合诊断准确度、特异度、敏感度均较高,值得临床借鉴。     

CRP及ESR在骨科内置物置入手术前后的变化及临床意义

目的观察C-反应蛋白(CRP)与红细胞沉降率(ESR)在骨科内置物置入手术前后的变化规律,并探讨其临床意义。方法选择骨科需行内置物置入手术的病人,共32例,对手术前后CRP及ESR进行连续监测,分析并比较监测结果。结果所有患者术后的CRP及ESR水平均升高。CRP于术后第2天达到峰值134.0 mg/L,以后缓慢降低,在术后1个月末下降到术前水平。ESR在术后第6天升至峰值81.5 mm/h,在术后3个月末回落到术前水平。结论CRP比ESR变化更快,更敏感;术后CRP峰值的高低与骨和骨髓创伤的严重程度相关;骨科内置物置入术后CRP恢复较慢;动态观察CRP和ESR有助于早期感染的发现和干预。     

抗感染治疗对乙型肝炎肝硬化并自发性细菌性腹膜炎的影响及分析

目的：探讨抗感染治疗对乙型肝炎肝硬化并自发性细菌性腹膜炎（SBP）患者血清降钙素原（PCT）和血清C-反应蛋白（CRP）水平的影响。方法对本院2012年1月至2013年2月所收治的98例乙型肝炎肝硬化患者的临床资料进行回顾性分析。结果乙型肝炎肝硬化患者血清PCT和CRP水平均显著高于对照组,且感染组血清PCT、CRP水平显著高于无感染组（F=4.419、5.807, P＜0.05）;感染组患者治疗后血清CRP、PCT水平显著下降（t=6.428、3.513,P＜0.05）;且经Spearman相关分析,患者血清CRP和PCT水平与SBP的严重程度具有良好的正相关性。结论血清PCT和CRP水平是诊断乙型肝炎肝硬化并SBP的重要指标,抗感染治疗可显著降低PCT和CRP的水平。     

中枢神经系统感染患儿检测β-内啡肽及C-反应蛋白的临床意义

目的探讨检测中枢神经系统感染患儿血及脑脊液（CSF）中β-内啡肽（β-EP）及C-反应蛋白（CRP）对早期鉴别诊断的临床意义。方法65例确诊中枢神经系统感染患儿设为观察组，其中病毒性脑炎组（病脑组）48例，化脓性脑膜炎组（化脑组）12例，结核性脑膜炎组（结脑组）5例，用放射免疫法分别测定急性期及恢复期的血及脑脊液中β-EP及CRP的含量，另外24例有神经系统症状但非中枢神经系统感染的患儿作为对照组。结果感染早期各观察组血浆及脑脊液β-EP含量均明显升高，高于对照组；恢复期上述指标明显下降。化脑组与其他两组及对照组相比，血清CRP浓度在急性期明显升高，恢复期明显下降；而病脑组和结脑组则始终在正常范围。各组脑脊液CRP浓度在急性期及恢复期无明显变化。结论测定血浆及脑脊液中β-EP的含量有助于早期诊断中枢神经系统感染，同时检测血清CRP有助于早期鉴别化脓性及非化脓性感染。     

The utility of C-reactive protein and procalcitonin for sepsis diagnosis in critically burned patients: A preliminary study

OBJECTIVE:

To assess the utility of C-reactive protein (CRP) and procalcitonin (PCT) as biomarkers of infection in patients with severe burn injury.

METHODS:

The present study included severe burn injury patients consecutively admitted to the Virgen del Rocío University Hospital (Andalucia, Spain) intensive care unit during a 12-month period. The variables of interest were: age, sex, mechanism of injury, percentage of burned body surface area, the Abbreviated Burn Severity Index (ABSI) and the absence/presence of sepsis. The authors analyzed serum levels of CRP and PCT at admission and every 48 h thereafter until intensive care unit discharge or death. Each determination was considered to be a sample or unit of analysis.

RESULTS:

A total of 157 determinations were analyzed from 17 severe burn injury patients. Fifty-four samples were considered to be septic, 25 of which corresponded to the first day of a new onset of sepsis. The mean duration of these symptoms was four days (interquartile range two to five days). Significant differences were found in the distributions of CRP and PCT values between sepsis and no-sepsis samples. Analysis of the changes in these biomarkers over time showed that PCT increase (ΔPCT) differentiated these diagnoses, whereas CRP increase (ΔCRP) did not. ROC curve analysis revealed that ΔPCT could predict positive sepsis samples (area under the curve 0.75 [95% CI 0.58 to 0.90]; P=0.003).

CONCLUSION:

These preliminary results showed that PCT had a better discriminatory capacity than CRP for identifying infectious processes in patients with severe burn injury. A larger sample size would be needed to confirm these results.     

Changes in the inflammatory markers with advancing stages of diabetic nephropathy and the role of pentraxin-3

Background: Immunological and inflammatory mechanisms have been shown to have role in both the development and progression of diabetic nephropathy (DNP). There is need for more specific markers for inflammation as the ones commonly used are influenced by many factors. Pentraxin-3 (PTX-3) seems to be a potential candidate. We aimed in our study to evaluate the changes of PTX-3 levels in different stages of DNP and its relationship with other inflammatory markers.

Methods: This is a cross sectional study in which patients with DNP at different stages were involved. Patient were divided into three groups according to estimated glomerular filtration rate (eGFR), microalbuminuria and proteinuria levels: Group-1: eGFR >60?mL/min and microalbuminuria, Group-2: eGFR >60?mL/min and macroalbuminuria, Group-3: eGFR <60?mL/min and macroalbuminuria. Besides the routine biochemical parameters, levels of PTX-3, high sensitivity C-reactive protein (hsCRP), interleukin (IL)-1 and tumor necrosis factor (TNF)-α was measured. Groups were compared with each other regarding the study parameters and correlation of PTX-3 with other markers was evaluated.

Results: The mean PTX-3 level in Group-2 (0.94?±?0.26?ng/mL) and -3 (1.35?±?1.55?ng/mL) were higher than in Group-1 (0.81?±?0.25?ng/mL) (p?=?0.009 and p?=?0.012). There was a significant correlation of PTX-3 with proteinuria (r?=?0.266, p?=?0.016), microalbuminuria (r?=?0.304, p?=?0.014) and hypoalbuminemia (r?=?0.197, p?=?0.043). PTX-3 was not correlated with other markers of inflammation (IL-1, TNF-α and hsCRP) and diabetic metabolic parameters (hbA1c, C-peptide, insulin and HOMA-IR). PTX-3, IL-1 and TNF-α levels increased with the advancing stage of DNP while hsCRP level did not change.

Conclusion: PTX-3 that increases similar to other markers of inflammation (IL-1, TNF-α) is a better inflammatory marker than hsCRP. Furthermore, there is a relationship between PTX-3 and proteinuria independent from eGFR.     

The impact of body mass index on the development of systemic inflammatory response syndrome and sepsis in patients with polytrauma

Purpose

Obesity is a growing problem in industrial nations. Our aim was to examine how overweight patients coped with systemic inflammatory response syndrome (SIRS) after polytrauma.

Methods

A total of 651 patients were included in this retrospective study, with an ISS ≥ 16 and age ≥ 16 years. The sample was subdivided into three groups: body mass index (BMI; all in kg/m²) < 25, BMI 25–30 and BMI > 30, or low, intermediate and high BMI. The SIRS score was measured over 31 days after admission together with measurements of C-reactive protein (CRP), interleukin-6 (IL-6) and procalcitonin (PCT). Data are given as the mean ± SEM if not otherwise indicated. Kruskal–Wallis and χ² tests were used for statistical analysis and the significance level was set at p < .05.

Results

The maximum SIRS score was reached in the low BMI-group at 3.4 ± 0.4, vs. 2.3 ± 0.1 and 2.5 ± 0.2 in the intermediate BMI-group and high BMI-group, respectively (p < .0001). However, the maximum SIRS score was reached earlier in the BMI 25–30 group at 1.8 ± 0.2 days, vs. 3.4 ± 0.4 and 2.5 ± 0.2 days in the BMI < 25 and BMI > 30 groups, respectively (p < .0001). The incidence of sepsis was significantly higher in the low BMI group at 46.1%, vs. 0.2% and 0% in the BMI 25–30 and BMI > 30 groups, respectively (p < .0001). No significant differences in the CRP, IL-6 or PCT levels were found between groups.

Conclusions

A higher BMI seemed to be protective for these patients with polytrauma-associated inflammatory problems.     

血清降钙素原检测对慢性重型乙型肝炎并发细菌感染的早期诊断价值

细菌感染是慢性重型乙型肝炎患者的常见并发症,也是导致患者病情加重和死亡的重要原因.慢性重型肝炎患者住院期间并发细菌感染的发生率为60％ ～ 70％,腹腔感染占首位,其次是肺部[1].研究显示,重型肝炎并发细菌感染患者的病死率明显高于非细菌感染患者[2].因此,如何早期发现并控制感染对改善重型肝炎的预后有重要的意义.降钙素原(PCT)近年来被认为是一种机体对细菌感染的全身炎症反应的特异性指标[3].血清PCT浓度的升高不仅可以判断是否存在全身细菌感染,而且可以反映感染的严重程度[4].本研究对慢性重型乙型肝炎并发细菌感染的患者进行血清PCT、C-反应蛋白(CRP)水平检测,探讨血清PCT检测对慢性重型乙型肝炎并发细菌感染的早期诊断价值.     

血清降钙素原、C反应蛋白和中性粒细胞CD64指数对脐静脉置管新生儿感染早期诊断价值

目的探讨血清降钙素原（PCT）、C反应蛋白（CRP）和中性粒细胞CD64指数对脐静脉置管新生儿感染的早期诊断和价值。 方法选择2017年3月至2019年6月绵阳市四〇四医院收治的脐静脉置管新生儿537例,其中发生感染患儿51例为感染组,未感染患儿486例为未感染组。比较两组新生儿血清PCT、CRP和中性粒细胞CD64指数,分析各指标及其相关性,并采用ROC曲线分析各指标对新生儿感染早期诊断价值。 结果入组患儿感染发生率为9.50%（51/537）。感染组患儿血清PCT、CRP和CD64指数均显著高于未感染组（[（16.31 ± 5.21）vs.（2.54 ± 0.63）,（12.31 ± 2.96）vs.（3.95 ± 1.20）,（2.97 ± 0.47）vs.（2.10 ± 0.35）],差异均有统计学意义（t = 30.904、27.883、13.822,P均< 0.001）。血清PCT与CRP（r =-0.316、P = 0.009）和CD64指数（r = 0.293、P = 0.015）间呈正相关,CRP与CD64指数亦呈正相关（r = 0.285、P = 0.018）。血清PCT、CRP、CD64指数单项指标诊断感染最佳截断值分别为7.28 ng/ml、6.12 mg/L和2.54,ROC曲线下面积分别为0.831、0.819和0.775;而PCT、CRP和CD64指数联合诊断新生儿感染曲线下面积为0.933。 结论血清PCT、CRP和中性粒细胞CD64指数对脐静脉置管新生儿早期感染具有较好的诊断价值,且3项指标联合应用可显著提高患儿早期感染诊断率。     

肝移植术后早期高胆红素血症分型及临床意义

目的 通过确立高胆红素血症的8种临床类型(简称分型)，使鉴别诊断的思路清晰化、条理化，在此基础上选择针对性较强的专项检查，达到及时明确诊断，减少医疗费用和提高管理质量的目的。方法 回顾性总结26例肝移植术后早期高胆红素血症的临床经过，筛选与高胆红素血症鉴别诊断相关的常规生化检测项目，选出DBIL、r-GT、IBIL、ALT作为观测指标和分型依据，根据DBIL和r-GT升高的时间和水平以及与IBIL、ALT是否同步或平行，将动态监测的4项指标绘制成坐标图，对照肝穿病理所见、影像学检查以及有确诊价值的其他检查结果，将高胆红素血症分为Ⅰ型(正常恢复型)、Ⅱ型(延迟恢复型)、Ⅲ型(溶血出血型)、Ⅳ型(肝无功能型)、Ⅴ型(急性排斥型)、Ⅵ型(肝内淤胆型)、Ⅶ(肝外阻塞型)以及Ⅷ型(不规则型)。依照分型对近期实施的肝移植病例进行前瞻性预测，并最后经病理或其他有确诊意义的检查结果验证分型的临床适用性和敏感性。结果 本组26例肝移植病人术后早期经历的高胆红素血症共61例次。其中Ⅰ～Ⅷ型的出现频度分别是7、5、5、1、21、11、7、4例次。呈现Ⅰ-Ⅶ型的57例次中，经病理学、影像学或有确诊意义的其他检查证实无误的有51例次，其中最近的7例次是依据分型做出前瞻性诊断后，及时采用针对性治疗并取得显著疗效。这些病人由此避免了高风险或高费用的检查。其余6例次虽可明确归属某一分型，但缺乏确诊意义的检查资料。概括导致高胆红素血症的原因包括：供肝再灌注损伤、轻度至中度排斥反应、肝内胆汁淤积、胆道并发症、药物性肝损害、腹腔内出血或血肿、局灶性肝坏死、肝动脉血栓形成、肝流出道梗阻、原发性供肝无功能等多种原因。分型中的各型分别与上述相应的原因有密切相关性。结论 导致肝移植术后高胆红素血症的常见原因基本上能分别归属于8种临床类型，各种类型与之所反映的并发症密切相关。依照各类型的特征性变化，临床医师可以对导致高胆红素血症的原因迅速做出初步判断，为及时采取针对性辅助检查和相应治疗措施赢得宝贵时间。该方法简便易行，节时省费，容易理解和掌握。     

In vivo and in vitro effects of simvastatin on inflammatory markers in pre-dialysis patients.

BACKGROUND: The beneficial effects of statins in reducing cardiovascular events have been attributed predominantly to their lipid-lowering effects, recent studies suggest that these effects might be due to their anti-inflammatory properties. We here investigate the in vivo and in vitro effects of simvastatin on cytokine production in pre-dialysis chronic renal failure patients. METHODS: Our clinical study has been designed as a randomized double-blind placebo controlled study. A total of 55 chronic kidney disease (CKD) patients at stages 3 and 4 (mean creatinine clearance 45 ml/min, range 15-60) were randomly assigned to receive simvastatin 40 mg/day or placebo, added to their ongoing treatment, for 6 months. Blood samples were obtained at baseline, and after 3 and 6 months of observation for the determination of lipids, inflammatory markers and renal function. For the in vitro studies, the effect of increasing doses of simvastatin on cytokine production [namely interleukin (IL)-6 and IL-8] in human cultured monocytes from 10 healthy subjects (HS) and 15 CKD patients stimulated by lipopolysaccharide (LPS) was investigated. RESULTS: A significant reduction in total cholesterol from 221+/-44 mg/dl to 184+/-41 mg/dl (3 months) and to 186+/-39 mg/dl (6 months) (P<0.02) and low-density lipoprotein cholesterol from 139+/-40 mg/dl to 104+/-29 mg/dl (3 months) and to 100+/-31 mg/dl (6 months) (P<0.001) was observed in the 28 patients treated with simvastatin. In this group, C-reactive protein (CRP) levels significantly decreased from 2.6 mg/l [interquartile range (IQR 4.9)] to 2.0 mg/l (IQR 1.9) (P = 0.03) at 6 months (P<0.05). A parallel reduction of IL-6 levels from 5.1 pg/ml (IQR 3.8) to 3.5 pg/ml (IQR 3.1) (P = 0.001) at 6 months was also observed. No significant reduction in inflammatory markers [CRP from 5.1 mg/l (IQR 1.9) to 5.4 mg/l (IQR 1.3) (P = NS) at 6 months] or plasma lipids [LDL-cholesterol from 127+/-32 mg/dl to 131+/-21 mg/dl (6 months)] was observed in the 27 patients of the placebo group. In the in vitro studies, the average value for cell-associated IL-6 and IL-8 was higher in CKD (155+/-95 pg/ml monocytes for IL-6 and 722+/-921 pg/ml monocytes for IL-8) vs HS (137+/-87 pg/ml monocytes and 186+/-125 pg/ml monocytes) (P<0.01) and was not affected by simvastatin alone. LPS resulted in a significant increase in cytokine production (IL-6: 1954+/-321 pg/ml monocytes for CKD and 1451+/-237 pg/ml monocytes for HS; P<0.001); the simultaneous addition of increasing doses of simvastatin to these cultures induced a dose-dependent inhibition of IL-6 and IL-8 production in stimulated peripheral blood mononuclear cells in all groups. CONCLUSIONS: These results indicate that simvastatin in commonly used doses has an in vitro and in vivo anti-inflammatory effect in CKD patients, and may play an important role in counteracting the mechanisms involved on the pathogenesis of cardiovascular disease.     

降钙素原和C-反应蛋白预测和鉴别大鼠急性胰腺炎并感染的研究

目的 探讨血浆降钙素原（PCT）及C-反应蛋白（CRP）对早期预测急性胰腺炎并感染的价值。方法 80只SD大鼠随机分为（1）急性胰腺炎并感染组（I组，n=20）；（2）急性胰腺炎对照组（C组，n=40），根据成模后腹腔有感染再分为C1和C2组；（3）假手术对照组（S组，n=20），采集成模前（0h）及成模后12，24h及48h时点血液和48h时点胰腺及肝脏组织，用ELISA法检测血浆CRP的浓度，Western Blot检测血浆和肝脏PCT水平结果 ⑴ B组大鼠腹腔均发生感染，C1组中16例腹腔发生感染，C2组20例未发生感染。⑵ B组和C1组血浆CRP水平呈持续上升趋势，在成模后48h 均显著高于C2组。⑶ B组和C1组血浆及肝脏组织内于成模后48h均能检到较高水平的PCT，且明显高于C2组及S组。结论 PCT对急性胰腺炎早期感染具有一定的预测作用；联合血浆CRP检测有助于鉴别胰腺炎是否合并感染。肝脏组织可能是PCT的一个重要合成部位。