血清降钙素原和C反应蛋白在急性胆管炎早期诊断和病情监测中的应用

探讨血清降钙素原(PCT)和C反应蛋白(CRP)对急性胆管炎早期诊断和病情监测的作用。回顾性选取2017年3月—2018年3月收治的肝胆管结石伴急性胆管炎患者(实验组,n=83)和肝胆管结石但无急性胆管炎患者(对照组,n=86)。急性胆管炎患者轻度41例、中度30例、重度12例。PCT和CRP的测定均采用免疫比浊法。治疗前对照组PCT和CRP都在正常值范围内;实验组血清PCT水平高于对照组(P0.05),按性别分层,男性PCT血清水平两组差异无统计学意义(P0.05),女性PCT血清水平实验组高于对照组(P0.05);实验组血清CRP水平明显高于对照组(P0.001),按性别分层后,男性和女性实验组血清CRP水平均高于对照组(P0.001)。通过分析实验组轻度、中度、重度患者的血清PCT和CRP水平,发现2个指标在3种不同程度的患者间差异有统计学意义(P0.001),即随着患者严重程度的升高,2个指标在血清的水平也逐渐升高。治疗后实验组血清PCT和CRP水平明显低于治疗前,差异有统计学意义(P0.001)。急性胆管炎的早期诊断和病情监测,可以通过测定治疗前后血清PCT和CRP水平,进行病情监测和疗效评估。     

不同面积脑梗死与C反应蛋白的临床研究

目的:探讨急性脑梗死( ACI)患者血清C反应蛋白(CRP)的临床意义.方法:测定102例不同梗死面积ACI患者血清CRP的水平,比较其水平差异.结果:三组ACI患者血清CRP均值均高于正常值,大、中面积组CRP显著高于小面积组和腔隙性组(P＜0.05).结论:CRP的水平可作为在一定程度上反映ACI患者病情严重程度的生化指标.     

炎症性肠病血清RDW、ESR、 ESR/CRP与疾病严重程度及疾病活动程度的关系

目的:分析炎症性肠病(IBD)血清红细胞体积分布宽度(RDW)、红细胞沉降率(ESR)、ESR/C反应蛋白(CRP)与疾病严重程度及疾病活动程度的关系。方法:将2021年1月至2022年5月我院诊治的IBD患者60例纳入病例组，选择同期体检健康者60名纳入对照组，检测与比较血清RDW、ESR、ESR/CRP值，评定疾病严重程度及疾病活动程度，并探讨其相关性。结果:病例组患者血清RDW、ESR均高于对照组(P<0.05),ESR/CRP比值低于对照组(P<0.05)。重度疾病严重程度患者血清RDW、ESR最高，ESR/CRP值最低。重度疾病活动程度患者血清RDW、ESR最高，ESR/CRP值最低。血清RDW、ESR水平与疾病严重程度及疾病活动程度呈正相关(P<0.05),ESR/CRP值与疾病严重程度及疾病活动程度呈负相关(P<0.05)。结论:血清RDW、ESR、ESR/CRP与IBD患者疾病严重程度及疾病活动程度有关，有望成为检查本病的生物标志物。     

血清降钙素原和C反应蛋白联合检测在急性胰腺炎危重度的早期评估及治疗的价值

目的探讨联合检测血清血清降钙素原(PCT)和C反应蛋白(CRP)对急性胰腺炎严重程度的早期判断价值及抗生素治疗指导价值。方法收集AP患者73例,其中重症胰腺炎(SAP)21例,轻症急性胰腺炎(MAP)52例,以及正常对照20例,分别在入院后第1、2、3、4天动态监测各位患者PCT和CRP水平,分析这些指标与AP严重程度及预后关系。结果MAP组和SAP组患者血清PCT及CRP水平均高于对照组(均P0.05),SAP组患者同期PCT及CRP水平均高于MAP组(均P0.05)。结论血清PCT和CRP能够在早期反映急性胰腺炎患者的病情严重程度,并且能够反映AP患者是否合并感染,有助于早期判断疾病的严重程度和早期合理预防感染,对AP的早期综合治疗具有一定的临床指导价值。     

血清降钙素原在重症病人感染早期诊断中的意义

目的:评价半定量测定血清降钙素原(PCT)对重症病人感染的早期诊断及其与疾病严重程度的相关性.方法:取121例体温>380C、符合全身炎症反应综合征临床表现并疑似感染的ICU重症病人人选,测定其血清PCT、C反应蛋白(CRP)、白细胞计数及分类,同时记录APACHEⅡ评分及全身性感染相关器官衰竭评分(SOFA).用半定量免疫色谱法测定血清PCT,散射免疫比浊法测定血清CRP.结果:121例入选病人按临床表现和细菌学检测结果分为感染组和非感染组.感染组的APACHEⅡ和SOFA评分明显高于非感染组(P<0.05).两组的血清PCT分布有显著性差异(x2=46.736,P=0.000),参照受试者工作特征曲线,以血清PCT≥2 ng/mL为阳性标准诊断感染的敏感度(80.65%)、特异性(77.78%)、阴性预测值(92.11%)及准确度(78.51%)均高于以CRP和WBC为诊断标准者.血清PeT与APACHEⅡ、SOFA评分呈明显正相关关系(P<0.01).结论:与CRP、WBC等传统炎症指标相比,血清PeT在重症病人严重感染的早期诊断中有一定诊断价值;且动态监测PCT水平有助于评估治疗效果.PCT与严重感染的脏器功能障碍程度及疾病的严重程度相关,是评估感染严重程度的较好参数.     

小儿感染性疾病CRP、IL-6水平变化相关性研究

目的:探讨小儿感染性疾病中血清C反应蛋白(CRP)、白介素6(IL-6)水平变化意义及相互关系.方法:检测观察组(感染性疾病患儿)49例、对照组(非感染性疾病患儿)49例,血清CRP、IL-6水平变化.结果:观察组患儿血清CRP、IL-6水平与对照组比较具有显著性差异(P＜0.05);观察组患儿治疗前后CRP、IL-6水平变化均具有显著性差异(P＜0.05),结果 CRP、IL-6在患儿感染发生、发展及预后密切相关,外周血CRP、IL-6可作为病情变化的重要指标之一.     

急性冠状动脉综合征患者使用辛伐他汀后血清基质蛋白酶9及C反应蛋白含量的变化

目的:探讨辛伐他汀对急性冠状动脉综合征(ACS)患者血清基质蛋白酶9(MMP-9)及C反应蛋白(CRP)含量的影响.方法:53例ACS患者被随机分为观察组27例和对照组26例,洲定治疗前、治疗4周后CRP和MMP-9水平.结果:2组治疗前CRP和MMP-9水平差异无统计学意义(p>0.05);治疗后2组CRP和MMP-9水平均明显低于治疗前,差异有统计学意义(p<0.05.p<0.01);治疗后观察组CRP和MMP-9水平明显低于对照组,差异有统计学意义(p<0.05).结论:辛伐他汀可降低ACS患者CRP和MMP-9水平.     

血清IL-6、CRP、PCT联合检测在结直肠癌术后感染诊断中的价值分析

目的:分析血清C-反应蛋白(CRP)、白介素-6(IL-6)、降钙素原(PCT)联合检测在结直肠癌术后感染诊断中的临床价值。方法:将我院2020-2022年接受治疗的结直肠癌术后感染患者30例作为观察组,选择同期未出现感染的患者30例作为对照组,检测并比较2组患者术后血清IL-6、CRP、PCT水平及对结直肠癌患者术后感染的诊断效能。结果:观察组患者术后3 d血清IL-6、CRP、PCT水平均高于对照组(P<0.05),三项联合诊断AUC最大,特异性及灵敏度最高。结论:血清IL-6、CRP、PCT水平在结直肠癌术后感染患者中高表达,联合检测其变化能提高术后感染的诊断效能。     

老年颈动脉硬化患者血清C反应蛋白测定及意义

目的:探讨 C 反应蛋白(C-reactive protein,CRP)作为系统性炎症因子在老年人颈动脉硬化中的改变及其意义。方法:选取经超声多普勒确诊的颈动脉硬化病人共130例,根据狭窄程度分为重组54例,轻组76例,对照组为经超声多普勒证实无颈动脉硬化病变的健康人,共45例。采用放射比浊法测定血清 CRP、放射免疫法测定血清白细胞介素-6(IL-6)浓度。结果:颈动脉硬化组血清 CRP 水平显著高于对照组(P<0.01);在颈动脉硬化患者中,重组血清 CRP 水平显著高于轻组(P<0.01),但两组间 IL-6浓度无显著差异(P>0.05)。结论:血清 CRP、IL-6水平在颈动脉硬化患者中明显升高,CRP 浓度与颈动脉狭窄程度密切相关。     

血清钙和C反应蛋白联合检测对急性胰腺炎危重度的早期预测价值

目的探讨联合检测血清钙和C反应蛋白(CRP)对急性胰腺炎(AP)严重程度的早期预测价值。方法回顾分析我院52例轻型急性胰腺炎(MAP)和21例重症急性胰腺炎(SAP)患者发病早期血清钙和C反应蛋白的变化规律,并对这两项指标预测SAP的诊断价值进行评估。结果入院第一天,AP病人血清CRP水平即明显增高,第二天达高峰,SAP组比MAP组增幅更为显著(P<0.001);此时CRP诊断SAP的灵敏度、特异度和ROC曲线下面积分别为85.7%、94.2%、0.904。与正常对照组比较,MAP组患者血清钙无明显变化P>0.05),而SAP组患者入院第1天血清钙水平即显著降低(P<0.01),随着时间推移,血清钙水平继续下降;血清钙诊断SAP的灵敏度、特异度和ROC曲线下面积分别为76.2%、96.1%,0.874。联合检测血清钙和CRP诊断SAP的灵敏度、特异度和诊断指数分别为95.2%,92.3%,1.88。结论血清钙和CRP联合检测对急性胰腺炎的危重程度有可靠的预测价值。     

A CRP genetic polymorphism associated with the tumoral expression of CRP in esophageal cancer

C-reactive protein (CRP) produced locally within esophageal cancer is associated with the prognosis and the rate of recurrence. CRP genetic polymorphisms reportedly affect serum CRP concentrations; however, there are no reports of an association between genetic polymorphisms and tumoral CRP expression. This study enrolled 73 Japanese patients classified with Stage IIA–IV thoracic esophageal squamous cell cancer, and also investigated their CRP genetic polymorphisms using DNA extracted from their peripheral blood. The study then assessed the association between CRP genetic polymorphisms and tumoral CRP expression. The results revealed a significant association between the CRP 1846C>T genetic polymorphism and tumoral CRP expression. This finding suggests that tumoral CRP production controlled by CRP genetics significantly influences tumor behavior.     

亚低温治疗颅脑损伤C反应蛋白的变化

目的　研究亚低温治疗颅脑损伤后血清C反应蛋白 (CRP)水平的变化。方法　通过对 40例颅脑损伤动物模型亚低温与非亚低温治疗后血清CRP水平的变化 ,比较其治疗效果。结果　常温组脑组织含水量为 ( 80 .3 6± 0 .86) % ,血清CRP水平为 ( 4 2 .3 5± 6.40 )mg/L ;亚低温治疗组脑组织含水量为 ( 77.43± 0 .3 9) % ,血清CRP水平为 ( 3 8.46± 8.43 )mg/L ,差异存在显著性 (P <0 .0 1)。结论　提示亚低温对治疗颅脑损伤有明显的治疗作用。     

No effect of C-reactive protein (CRP) haplotypes on CRP levels and post-transplant morbidity and mortality in renal transplantation

Increased serum C-reactive protein (CRP) levels have been associated with all-cause and cardiovascular mortality after kidney transplantation. As genetic variations within the CRP gene determine CRP serum levels, we analyzed the association of both serum CRP levels, and post-transplant morbidity/mortality with CRP-genotypes/haplotypes. We determined CRP levels pretransplant, at 3 and 6 months post-transplant in 402 first kidney recipients, genotyped the three functionally distinct polymorphisms, and subsequently reconstructed the different haplotypes. Four different CRP-haplotypes were observed with a frequency >1%: CGC (33.3%), CGT (30.2%), CAT (29.7%) and GGT (6.8%). CRP levels pretransplantation or 3 and 6 months post-transplant were not different in patients with different CRP-haplotypes. Furthermore, no association of CRP-haplotypes/diplotypes was found with acute rejection, delayed graft function, all-cause mortality or cardiovascular events. In our renal transplant population, we found no association of CRP-haplotypes/diplotypes with either CRP levels or with post-transplant morbidity/mortality. In this inflammation-prone population, rather small genetically determined differences in serum CRP observed in normal populations presumably are overridden by background inflammation. Life long genetically determined increased serum CRP levels appear not to have an impact in our study, implying that CRP is more likely only a marker of current inflammation than a causative agent of cardiovascular morbidity and mortality.     

Circulating CRP and calprotectin to diagnose CF pulmonary exacerbations

Cystic fibrosis (CF) pulmonary exacerbations (PEx) remain underdiagnosed by CF clinicians. Serum C-reactive protein (CRP) and calprotectin are inflammatory biomarkers that have the potential to aid in the diagnosis of PEx. 19 subjects (56 stable, 46 PEx visits) from a longitudinal study were included and the diagnostic performance of absolute and fold-change CRP and calprotectin cut-offs to discriminate stable and PEx visits was assessed. Based on Youden's index, optimal absolute and fold-change thresholds to identify PEx were 9.5 mg/L (Sn 76%, Sp 73%; AUC 0.76) and 2.2-fold (Sn 50%, Sp 96%; AUC 0.78) for CRP and 8.1 mg/L (Sn 61%, Sp 79%; AUC 0.72) and 1.3-fold (Sn 57%, Sp 88%; AUC 0.74) for calprotectin. A step-wise algorithm was able to improve diagnostic performance (Sn 80%; Sp 88%). CRP and calprotectin could discriminate stable vs. PEx visits with good performance and appear promising as diagnostic biomarkers but further validation studies are required prior to implementing these diagnostic thresholds.