High sensitivity C-reactive protein.

Though there is no apparent relationship between CRP and cardiovascular disease, the hsCRP may be the most effective single marker of disease among otherwise healthy adults, and is certainly an effective marker when employed in combination with other proven markers such as fibrinogen, homocysteine, and lipid assays. The hsCRP test may not be particularly useful among inpatients, however, as it is typically elevated in acute inflammatory disease. In addition to its apparent ability to predict the risk of cardiovascular disease, the hsCRP test points the way to further identification of risk markers.     

High sensitivity C-reactive protein (CRP) reference intervals in the elderly.

High sensitivity C-reactive protein is a useful marker in clinical practice; however, reference intervals are not available for all age groups. Therefore, the aim of this study was to determine reference intervals for elderly people. The non-parametric reference limits were calculated for the two genders, subdivided into two age classes (50-64 and 65-91 years). In our selected sample population, we did not observe significant gender differences.     

血脂及高敏C-反应蛋白对急性冠脉综合征患者长期预后的预测价值

目的评价血脂及高敏C反应蛋白（hs-CRP）对急性冠脉综合征（ACS）患者长期预后的预测价值，探索ACS患者危险分层简便、实用的方法。方法连续入选ACS患者246名，测定其基线水平的hs-CRP、肌钙蛋白T（cTnT）、血清总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）等指标。观察住院及随访期间主要心血管事件（包括心源性死亡、再发非致命性心肌梗死和因严重心绞痛而再次入院）的发生情况，据此将患者分为事件组和对照组；筛选可独立预测终点事件的指标，并评价其单独及联合预测价值。所有资料均采用SPSS13．0软件进行分析。结果完成随访241例，其中121例发生心血管事件。事件组和对照组患者的年龄、白细胞计数、hs-CRP、LDL-C／HDL-C和cTnT阳性率均有显著差异（P〈0．05），行Logistic回归分析后只有TC／HDL-C和hs-CRP进入回归方程（P〈0．01）。根据TC／HDL-C和hs-CRP的三分位数对患者进行危险分层，发现随着TC/HDL-C和hs-CRP的升高，患者的心血管事件发生率均呈上升趋势，二者均位于最高三分位数区间的患者的终点事件发生率最高（78．1％）。结论TC／HDL-C和hs-CRP均可以独立预测ACS患者长期再发心血管事件的危险；TC／HDL-C和hs-CRP联合应用的分层效果更佳，hs-CRP可以对经传统血脂所确定的“低危”患者进一步分层，筛选出心血管事件发生率相对较高者。     

严重创伤后超敏C反应蛋白与T淋巴细胞亚群变迁之间的关系

目的探讨严重创伤患者血清超敏C反应蛋白(hs-CRP)与T淋巴细胞亚群变迁之间的关系及其意义。方法将83例严重创伤患者(ISS评分≥16分)按治疗过程中是否并发感染分为感染组和非感染组,检测患者伤后第1、2、3、7天hs-CRP与T淋巴细胞亚群的水平。实验同时以20例健康人作健康对照组进行比较研究。结果非感染组hs-CRP水平先升高后降低,总T细胞(CD3+)、T4细胞(CD3+CD4+)、T4/T8比值(CD3+CD4+/CD3+CD8+)的水平先降低后升高,T8细胞(CD3+CD8+)水平先升高后降低,而感染组hs-CRP水平持续升高,总T细胞、T4细胞、T4/T8的水平持续降低,两组患者在伤后各天hs-CRP、T细胞亚群的变化与健康对照组比较都差异有统计学意义(P<0.05)。感染组与非感染组间各时相点比较差异均有统计学意义(P<0.05)。严重创伤患者的hs-CRP峰值与总T细胞、T4细胞、T4/T8的水平呈显著负相关(相关系数分别为r1=-0.67,r2=-0.71,r3=-0.61,均P<0.05)。结论严重创伤后急性期患者细胞免疫功能受到抑制,炎症因子hs-CRP与T淋巴细胞亚群变迁有相关性,与创伤严重程度及有无并发感染的发生密切相关,根据病情程度和时限变化主动给予适当的免疫调控,并制定有效的抗感染治疗方案,对救治严重创伤患者有重要的临床意义。     

川崎病后超敏C-反应蛋白及血脂水平检测的临床意义

目的探讨血清超敏C-反应蛋白(high sensitivity C-reactive protein,Hs-CRP)和血脂水平与川崎病慢性期炎症的关系。方法川崎病患儿80例,分成两组,冠状动脉扩张组35例和冠状动脉无扩张组45例,对照组为健康儿童40例。采用免疫比浊法检测血Hs-CRP水平,酶法检测血总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平。结果三组儿童Hs-CRP、HDL-C浓度差异均有显著性(P<0.05),且冠状动脉扩张组均高于冠状动脉无扩张组和对照组(P<0.05);logistic回归分析示Hs-CRP、HDL-C与冠状动脉扩张密切相关。结论川崎病急性期过后仍有部分儿童存在血管的慢性低水平炎症,Hs-CRP与HDL-C是川崎病慢性期冠状动脉病变的可靠预测指标。     

冠心病患者血清超敏C反应蛋白测定意义

目的 研究血清超敏C反应蛋白(high sensitivly C reactive protein,hs-CRP)在冠心病患者中的变化及意义。方法 随机选取138例冠心病患者,包括心肌梗塞患者43例,不稳定心绞痛患者45例,稳定心绞痛患者50例,50健康人做对照。应用散射速率比浊法测定血清超敏hsCRP浓度。结果急性心肌梗塞、不稳定心绞痛和稳定性心绞痛患者血清中hsCRP的浓度与正常对照组相比明显增高,差异具有统计学意义(P<0.001),血清hsCRP的P25为2.61mg/L,P50为9.50mg/L,P75为33.40mg/L,冠心病患者的血清hsCRP在各百分位点的分布与正常对照在各百分位点的分布相比有显著性差异(P<0.001)。而急性心肌梗塞患者、不稳定心绞痛和稳定性心绞痛患者之间无显著性差异(P>0.05)。结论 血清hsCRP在冠脉事件发生时增高,可以作为冠脉事件预报,并且是一个独立的心血管疾病危险因素。     

冠心病患者血清超敏C反应蛋白测定意义

目的研究血清超敏C反应蛋白(high sensitivty C reactive protein,hs-CRP)在冠心病患者中的变化及意义.方法随机选取138例冠心病患者,包括心肌梗塞患者43例,不稳定心绞痛患者45例,稳定心绞痛患者50例,50健康人做对照.应用散射速率比浊法测定血清超敏hsCRP浓度.结果急性心肌梗塞、不稳定心绞痛和稳定性心绞痛患者血清中hsCRP的浓度与正常对照组相比明显增高,差异具有统计学意义(P＜0.001),血清hsCRP的P25为2.61mg/L,P50为9.50mg/L,P75为33.40mg/L,冠心病患者的血清hsCRP在各百分位点的分布与正常对照在各百分位点的分布相比有显著性差异(P＜0.001).而急性心肌梗塞患者、不稳定心绞痛和稳定性心绞痛患者之间无显著性差异(P＞0.05).结论血清hsCRP在冠脉事件发生时增高,可以作为冠脉事件预报,并且是一个独立的心血管疾病危险因素.     

High sensitivity C-reactive protein: an emerging role in cardiovascular risk assessment

Coronary heart disease (CHD) is the major cause of death in the developed world and screening for conventional cardiovascular risk factors fails to identify more than 50% of the individuals who will present with acute coronary syndromes. Chronic inflammation appears to play a significant role in the initiation and development of atherosclerosis. Recent investigations have shown an association between inflammatory markers such as C-reactive protein (CRP) and CHD. These markers have proven useful as prognostic indicators in acute coronary syndromes and in predicting future coronary events in apparently healthy men and women. The availability of high sensitivity CRP (hs-CRP) assays has been crucial in exploring the role of this acute phase reactant in primary prevention settings. In this review, we discuss the evidence associating these inflammatory markers, especially CRP, with the pathogenesis of atherosclerosis and acute coronary syndromes, and we address the mechanism of risk as well as the clinical utility of this marker.     

High sensitivity immunoassays for C-reactive protein: promises and pitfalls.

C-reactive protein (CRP) has historically been measured in the clinical laboratory for the detection and monitoring of occult infection and inflammation, using immunoturbidimetric or immunonephelometric techniques. The recent commercial availability of automated high-sensitivity assays has enabled investigators to measure CRP at levels previously unattainable on a routine basis and to explore its clinical utility in apparently healthy individuals. CRP concentrations increased above the individuals' baselines but still within the normal reference intervals have been observed in association with increasing age, obesity, and smoking and in individuals with chronic infections such as Chlamydia pneumoniae and Helicobacter pylori. More importantly, however, data from prospective studies have shown CRP to be a strong and independent predictor of future coronary events in subjects with and without coronary heart disease. An algorithm for risk assessment of coronary risk employing both CRP and lipid concentrations has recently been proposed. However, in order for this approach to be incorporated into clinical practice, agreement among the various CRP methods must be achieved. Of critical importance to this process is a basic understanding of issues affecting assay performance. Factors such as assay precision, sensitivity, matrix effects, calibration, and standardization need to be addressed adequately by the in vitro diagnostic industry and the clinical laboratory.     

High sensitivity C-reactive protein: biological variations and reference limits.

Serum C-reactive protein (CRP) concentration was determined for 3605 subjects using an immunonephelometric assay improved to provide greater sensitivity. Subjects were from 5 to 75 years old and belonging to 1003 nuclear families recruited from the Stanislas Cohort Study between January 1994 and August 1995. Sample values for CRP ranged from 0.17 mg/l to 100 mg/l. Geometric means (mean - SD; mean +/- SD) were in the 5-14 years old group 0.37 (0.17-1.07) mg/l, in the 15-28 years old group 0.47 (0.17-1.38) mg/l and in the 29-75 years old group 0.98 (0.34-2.85) mg/l. For women, the geometric means were 0.38 (0.17-1.10) mg/l, 0.62 (0.20-1.90) mg/l and 0.98 mg/l (0.31-3.13) mg/l respectively. The interindividual variability ranged from 138% to 759% among different age classes. Biological factors associated with CRP concentration variations were examined and accounted for 25% of the CRP variability in men and 40% in women. The main biological factors statistically associated with CRP concentration variations in men were: drugs, leukocyte count, body mass index, tobacco consumption, age, and in women: drugs, leukocyte count, age, body mass index and hemoglobin concentration. These factors were used to define the exclusion and partition criteria when obtaining the reference samples. Medians for reference values ranged from 0.20 to 0.68 mg/l in males and from 0.20 to 0.78 mg/l in women.     

血清高敏C反应蛋白在前列腺穿刺活检诊断前列腺癌中的意义

目的探讨血清高敏C反应蛋白(hs-CRP)在前列腺穿刺活检诊断前列腺癌中的意义。方法选取行经直肠超声引导下前列腺穿刺活检患者347例,经病理确诊前列腺癌122例和良性前列腺增生225例。比较前列腺癌和良性前列腺增生患者年龄、血清hs-CRP、总前列腺癌的特异性标志物(tPSA)、前列腺总体积(TPV)及PSA密度(PSAD)等指标,比较血清hs-CRP升高者与正常者有关指标及穿刺阳性率,对影响前列腺穿刺阳性率相关指标进行Logistic回归分析。结果前列腺癌患者血清hsCRP浓度(3.57±1.25)mg/L,显著高于良性前列腺增生患者的(1.36±0.97)mg/L,差异具有统计学意义(P0.05);血清hsCRP浓度3 mg/L组患者tPSA和PSAD均高于≤3 mg/L组;穿刺阳性率为57.3%,显著高于≤3 mg/L组的26.5%(P0.05),且差异具有统计学意义(P0.05);Logistic回归分析显示,年龄、hs-CRP、tPSA和TPV是前列腺穿刺阳性率的独立影响因素(P0.05),hs-CRP的OR值=1.132(95%CI:1.027~1.307),高于其他3个因素。结论对怀疑前列腺癌行经直肠前列腺穿刺活检的患者应进行血清hs-CRP检测,血清hs-CRP浓度升高时穿刺活检前列腺癌检出率提高。     

血清高敏C-反应蛋白与冠状动脉病变程度的分析

目的探讨高敏C-反应蛋白（hs-CRP）与冠状动脉病变程度的相关性。方法测定40例稳定性心绞痛患者（SAP组）、50例不稳定心绞痛患者（UAP组）、30例急性心肌梗死患者（AMI组）及60例健康者（对照组）的hs-CRP及心肌肌钙蛋白Ⅰ（cTnI）、肌酸激酶（CK）、肌酸激酶同工酶（CK-MB）等心肌标志物水平。结果 hs-CRP水平在对照组、SAP组、UAP组和AMI组分别为（2.3±0.5）mg/L、（4.2±0.6）mg/L、（6.4±1.0）mg/L、（14.7±2.9）mg/L,各组间存在显著递增趋势,即AMI组〉UAP组〉SAP组〉对照组。而cTnI仅UAP组和AMI显著升高,CK和CK-MB仅在AMI组显著升高。结论 hs-CRP水平与冠状动脉病变程度密切相关。     

骨关节炎患者高敏C反应蛋白测定的临床意义

目的:了解高敏C反应蛋白(hs-CRP)对骨关节炎(OA)患者病情评估的作用。方法:用免疫增强透射比浊法检测20例活动期膝关节OA患者和23例放射学(无症状)膝OA患者的hs-CRP水平,并与20例正常人相比较。结果:有膝关节疼痛的活动期OA患者的hs-CRP水平明显高于放射学无症状OA患者(P<0.01),且两组患者的血清hs-CRP水平均高于正常对照组(分别为P<0.01及P<0.05)。20例活动期患者经治疗症状减轻后hs-CRP水平明显下降(P<0.05),但仍高于正常对照组(P<0.01)。结论:hs-CRP是评估OA活动性及监测其治疗效果的一种敏感的血清学指标。     

脑梗死患者血清同型半胱氨酸和高敏C反应蛋白水平分析

目的：观察脑梗死患者血清同型半胱氨酸（Hcy）和高敏C反应蛋白（hs-CRP）水平的变化，探讨两者与脑梗死严重程度的关系。方法：测定74例脑梗死患者和70例健康对照者的血清Hcy、hs-CRP含量，并分析其与脑梗死患者临床神经功能缺损程度评分的相关性。结果：脑梗死患者血清Hcy、hs-CRP水平明显高于健康对照组（P〈0．01）。脑梗死不同临床分型组间血清Hcy、hs-CRP水平两两比较，Hcy差异无统计学意义（P〉0．05），hs-CRP差异有统计学意义（P〈0．01）。脑梗死患者血清hs-CRP含量与临床神经功能缺损程度评分呈显著正相关（r=0．631，P〈0．05）。结论血清Hcy、hs-CRP水平增高与脑梗死的发生有密切关系，hs-CRP能反映脑梗死的病变程度。     

正常体质量多囊卵巢综合征患者血清睾酮与高敏C反应蛋白水平的关系

目的探讨正常体质量的多囊卵巢综合征患者血清睾酮与高敏C反应蛋白水平的关系。方法正常体质量多囊卵巢综合征患者83例,检测其血清睾酮及高敏C反应蛋白水平;依据血清睾酮水平进行分组,比较2组高敏C反应蛋白水平差异。结果 83例患者中血清睾酮增高36例（睾酮增高组）,睾酮水平正常47例（睾酮正常组）;睾酮增高组与睾酮正常组患者血清高敏C反应蛋白水平比较差异无统计学意义（P〉0.05）。结论体质量正常的多囊卵巢综合征患者其血清睾酮增高并不增加高敏C反应蛋白水平;血清睾酮水平作为独立因素,不增加正常体质量的多囊卵巢综合征患者远期心血管并发症的发生率。     

血清髓过氧化物酶和高敏C反应蛋白与冠状动脉粥样硬化的相关性研究

目的 探讨血清髓过氧化物酶(MPO)和高敏C反应蛋白(hs-CRP)在冠状动脉粥样硬化不同程度中的变化.方法 应用酶联免疫吸附试验(EHSA)测定67例经冠状动脉造影证实的冠心病患者和20例造影阴性对照者的MPO水平,冠心病患者按造影结果分为3组.用免疫透射比浊测定hs-CRP,同时检测血清中的总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)的水平以及白细胞(WBC)计数等指标.结果 造影阴性组MPO水平为(4.53±1.26)U/mL,病例组中狭窄程度≤50%为(4.35±1.12)U/mL,50%＜狭窄程度≤75%为(3.57±0.77)U/mL,狭窄程度＞75%为(2.92±0.47)U/mL.除狭窄程度≤50%组外,其他病例组血清MPO水平均显著低于造影阴性组.hs-CRP则与之相反.MPO水平与WBC计数呈正相关(r=0.389,P=0.003).结论 MPO在血清中的低水平表达可作为冠状动脉粥样硬化的危险因子,是独立于hs-CRP的炎症标志物.     

Homogeneous determination of C-reactive protein in serum using liposome immune lysis assay (LILA)

Recently, we have developed an analytical system based on a complement dependent liposome immune lysis assay (LILA) to measure antibody against protein antigens. This paper describes the application of LILA to measure protein antigens by inhibition reaction. We choose human C-reactive protein (CRP), one of acute phase reactants, for a model of antigen determination. CRP antigen is coupled to the carboxyfluorescein entrapped multilamellar liposomes by using N-hydroxysuccinimidyl 3-(2-pyridyldithio) propionate and dithiothreitol, and a specific lysis of liposomes is achieved upon the addition of anti-CRP antibody in the presence of complement. Inhibition of this assay can be observed by the addition of competing amounts of CRP in human serum. This inhibition assay is simple, fast, highly sensitive, reproducible and homogeneous. The assay covers the ranges 10-500 micrograms/l. In an experiment using 50 samples, the results by LILA correlated well with those by single radial immunodiffusion and enzyme immunoassay (correlation coefficient: 0.99 and 0.93, respectively).     

超敏C反应蛋白与2型糖尿病患者动脉粥样硬化的相关性研究

目的探讨血清超敏C反应蛋白(hs-CRP)与2型糖尿病患者颈动脉粥样硬化的相关性。方法收集83例2型糖尿病患者和40例体检健康者血清,根据患者血清低密度脂蛋白胆固醇(LDL-C)水平将糖尿病组患者分为LDL-C水平增高组和LDL-C水平正常组,测定所有受检者血清hs-CRP水平及糖尿病患者颈动脉内膜中层厚度(IMT)。结果 hs-CRP水平在LDL-C增高组、正常组及对照组之间呈逐渐下降趋势,两两比较,差异具有统计学意义(P0.01);hs-CRP浓度与LDL-C浓度呈正相关(r=0.4781,P0.05);2型糖尿病患者中合并颈动脉粥样硬化者血清hs-CRP阳性率明显高于无颈动脉病变者(P0.01)。结论 2型糖尿病患者血清hs-CRP水平显著升高,且与患者LDL-C浓度及颈总动脉粥样硬化形成有一定的相关性。