C反应蛋白在新生儿败血症的应用及评价

目的 探讨血清C反应蛋白(CRP)、高敏C反应蛋白(sCRP)浓度对诊断新生儿败血症的敏感性和特异性,为临床提供准确快速的诊断依据.方法 用比浊法测定新生儿败血症患者的CRP、sCRP浓度,并与WBC计数进行比较.结果 CRP、sCRP对诊断新生儿败血症的敏感性均高于WBC计数,3个指标中敏感性以sCRP最高;特异性、阳性预测值以CRP最高;阴性预测值和约登指数CRP、sCRP两者相差无几.结论 C反应蛋白浓度检测对新生儿败血症的早期诊断有一定价值.     

新生儿败血症血培养阳性者CRP正常的原因分析

新生儿败血症血培养阳性者ＣＲＰ正常的原因分析王振营河北峰峰矿务局第二医院关键词败血症，Ｃ反应蛋白Ｃ反应蛋白（ＣＲＰ）是诊断败血症参考指标之一，但多种因素可影响其结果。笔者１９９２年１月～１９９４年１１月收治的新生儿败血症１２０例，其中５０例ＣＲＰ正常...     

降钙素原检测在新生儿败血症早期诊断中的应用

目的：探讨血清降钙素原(PCT)作为早期诊断新生儿败血症指标的应用价值。方法应用固相免疫测定法测定84例新生儿血清中降钙素原(PCT),C反应蛋白(CRP)水平,其中败血症组30例、一般感染组28例、非感染组26例。结果败血症组患儿血清PCT、CRP水平显著高于一般感染组和非感染组,差异有统计学意义(P<0.05);一般感染组与非感染组血清中PCT、CRP水平比较差异有统计学意义(P<0.05)。以0.5ng/mL为临界值,PCT诊断新生儿败血症的敏感度为93.3%,特异度为80.8%;以8.0mg/L为临界值,诊断败血症的敏感度为70.0%,特异度为69.2%。与CRP相比,PCT诊断败血症的敏感性、特异性更高。经抗生素有效治疗后,血清PCT下降幅度明显大于血清CRP下降幅度。结论新生儿血清PCT水平的检测对败血症的早期诊断与疗效评价具有重要价值。     

新生儿超敏C反应蛋白水平观察及研究

目的探讨超敏CRP(hsCRP)在新生儿的动态变化及应用价值．方法对我院新生儿病房的出生24h、72h、7d检测。hsCRP．结果109例3d内＞3mg／L者为34例(31．2％)，其中24h内＞3mg/L者为25例(22．9％)．7d后97．1％降至＜3mg／L．无异常分娩史早产组，早产组hsCRP值72h高于24h和7d(p＜O．05)，足月组。72h高于24h(p＜O．05)与7d无差异(p＞O．05)、24h和。72h两组无差异(P＞O．05)，7d足月组高于早产组(P＜O．05)．足月儿7d hsCRP值明显升高．结论对于早期新生儿，尤其有异常分娩史者应常规检测hsCRP，并观察动态变化，对新生儿疾病的早期诊断、判定疗效有重要意义．     

新生儿超敏C反应蛋白水平观察及研究

目的探讨超敏CRP(hsCRP)在新生儿的动态变化及应用价值.方法对我院新生儿病房的出生24h、72h、7d检测hsCRP.结果 109例3d内＞3mg/L者为34例(31.2 %),其中24h内＞3mg/L者为25例(22.9%),7d后97.1%降至＜3mg/L.无异常分娩史早产组,早产组hsCRP值72h高于24h和7d(p＜0.05),足月组72h高于24h(p＜0.05)与7d无差异(p＞0.05)、24h和72h两组无差异(p＞0.05),7d足月组高于早产组(p＜0.05).足月儿7d hsCRP值明显升高.结论对于早期新生儿,尤其有异常分娩史者应常规检测hsCRP,并观察动态变化,对新生儿疾病的早期诊断、判定疗效有重要意义.     

闽东地区新生儿败血症54例分析

目的 为了解闽东地区新生儿败血症临床表现、主要病原菌及其药敏情况。方法 本篇回顾性分析了54例2000年2月～2003年4月闽东医院儿科住院的血培养阳性的新生儿败血症患儿的临床表现、主要病原菌、药敏实验结果。结果主要临床表现:黄疸占48.1％,少哭、少动、少吃、反应差占46.3％,外周血象WBC<10 × 109/L占37.1％。金黄色葡萄球菌败血症26例(占48.1％)和表皮葡萄球菌16例(占29.6％)为主要致病菌。几乎全部对青霉素及红霉素耐药,对菌必治与先锋V敏感率>73.1％,尚未发现耐万古霉素的菌株。结论 新生儿出现黄疸、反应差等临床表现即使血白细胞不高也需考虑败血症的可能,治疗首选抗菌素为先锋V。     

新生儿窒息血清超敏C反应蛋白和心肌酶检测的临床应用

目的探讨新生儿窒息后血清超敏C反应蛋白（hs-CRP）和心肌酶水平变化与窒息程度的相关性。方法选择出生时窒息新生儿102例,轻度窒息62例,重度窒息40例为观察对象,无窒息新生儿40例为正常对照组,于出生后72h内静脉采血3ml,采用奥林巴斯2700全自动生化分析仪检测血清hs-CRP和心肌酶。结果新生儿窒息后血清hs-CRP和心肌酶水平显著升高,其升高程度与新生儿窒息程度呈正比。结论通过检测窒息新生儿hs-CRP和心肌酶能及时发现心肌损害,对判断病情和估计预后有重要的临床意义。     

新生儿败血症时急性期蛋白变化与免疫调节关系的探讨

测定新生儿败血症时血清的１２种急性期蛋白成分，结果表明，败血症新生儿血清α１ＡＴ含量比正常新生儿明显增高，α１ＡＧ、ＨＰ、ＣＰ、Ｃ１ｑ、Ｃ４、Ｃ５、Ｃ９、Ｂｆ含量均极显著高于正常新生儿，而α２Ｍ含量比正常新生儿明显降低，Ｔｆ含量极显著低于正常新生儿，Ｃ３含量无显著变化。说明新生儿在受到细菌感染及其毒素刺激时，同样能有年长儿以至成人的抗感染急性期反应。文中对急性期蛋白变化的生理病理意义及其在机体抗感染免疫调节网络中的作用进行了分析。     

新生儿窒息后血清超敏C反应蛋白和心肌酶的检测及分析

目的探讨超敏C反应蛋白（hs—CRP）和心肌酶的检测在新生儿窒息后心肌损伤中的诊断价值。方法将入选新生儿分为二组,对照组31例,窒息组75例（轻度窒息46例,重度窒息29例）,分别测定两组新生儿出生后24h内和第8天的血hs—CRP和心肌酶,并比较分析。结果轻度和重度窒息新生儿血清hs—CRP和心肌酶水平显著高于对照组（P〈0．05和（P〈0．01）,重度窒息组血hs—CRP和心肌酶水平高于轻度窒息组（P〈0．05）,治疗后窒息组hs—CRP和心肌酶水平明显下降,但重度组仍略高于轻度组,差异无显著性（P〉0．05）。结论新生儿窒息缺氧可导致心肌损伤,血清hs—CRP和心肌酶检测可作为判断心肌损伤及严重程度的指标。     

冠心病患者C反应蛋白与血脂检测结果分析

目的对冠心病患者进行CRP与血脂的检测,探讨二者的相关性。方法OLYMPUS-640全自动生化分析仪分析CRP与血脂。结果CHD患者CRP、TC、TG、LDL、apoB、Lp（a）均显著高于正常组（P〈0.01）,HDL、apoA低于正常组（P     

Cardiac troponin and C-reactive protein for predicting all-cause and cardiovascular mortality in patients with chronic kidney disease: A meta-analysis

Elevated serum levels of cardiac troponin and C-reactive protein are associated with all-cause and cardiovascular mortality in patients with end-stage renal disease. However, the relationship between these two biomarker levels and mortality in patients with chronic kidney disease remains unclear. We conducted a meta-analysis to quantify the association of cardiac troponin and C-reactive protein levels with all-cause and cardiovascular mortality in patients with chronic kidney disease. Relevant studies were identified by searching the MEDLINE database through November 2013. Studies were included in the meta-analysis if they reported the long-term all-cause or cardiovascular mortality of chronic kidney disease patients with abnormally elevated serum levels of cardiac troponin or C-reactive protein. Summary estimates of association were obtained using a random-effects model. Thirty-two studies met our inclusion criteria. From the pooled analysis, cardiac troponin and C-reactive protein were significantly associated with all-cause (HR 2.93, 95% CI 1.97-4.33 and HR 1.21, 95% CI 1.14-1.29, respectively) and cardiovascular (HR 3.27, 95% CI 1.67-6.41 and HR 1.19, 95% CI 1.10-1.28, respectively) mortality. In the subgroup analysis of cardiac troponin and C-reactive protein, significant heterogeneities were found among the subgroups of population for renal replacement therapy and for the proportion of smokers and the C-reactive protein analysis method. Elevated serum levels of cardiac troponin and C-reactive protein are significant associated with higher risks of all-cause and cardiovascular mortality in patients with chronic kidney disease. Further studies are warranted to explore the risk stratification in chronic kidney disease patients.     

新生儿严重细菌感染血浆降钙素原与CRP和IL-6临床价值对比研究

目的：比较新生儿败血症及败血症休克血降钙素原（PCT）与C反应蛋白（CRP）和白介素-6（IL-6）的变化，探讨血中前降钙素原作为新生儿严重细菌感染诊断指标的敏感性、可靠性及对预后评估的作用。方法：采用半定量固相免疫测定法测定108例新生儿败血症（40例合并败血症休克）的血浆PCT水平，并比较同期CRP和IL-6水平。结果：新生儿败血症患儿血浆PCT阳性检出率明显高于正常对照组；其中败血症休克组尤为明显；败血症休克患儿发生率及死亡率随PCT值升高而升高；PCT与血清CRP、IL-6水平呈正相关；PCT的敏感性（87．5％）、特异性（82．4％）、阳性预测值（74．5％）和准确性（84．3％）最高。结论：新生儿败血症及败血症休克时PCT升高较早，且随病情的加重持续升高。PCr对新生儿败血症及败血症休克诊断指标的敏感性、可靠性及对预后评估优于CRP和IL-6。     

新生儿败血症病原菌与临床药敏试验的分析

目的了解目前福州地区新生儿败血症病原菌的分布及药物敏感性现状,结合临床以制定相应对策,合理选择抗生素。方法对1998年1月至2003年12月住院的经血培养证实阳性的125例新生儿败血症的临床资料进行回顾性分析。结果125例败血症共分离出病原菌148株,以葡萄球菌居多(37.8%)。晚期新生儿的败血症发生率高于早发性。早产儿易感肺炎克雷伯杆菌,足月儿易感葡萄球菌。由于青霉素除对B族链球菌敏感率为66.7%,其余均普遍耐药。葡萄球菌对氨苄青霉素、头孢唑林、苯唑青霉素的耐药率在70%左右。敏感药物主要有万古霉素、亚胺培南等。革兰阴性杆菌对氨苄青霉素的总耐药率93.3%,对第三代头孢类及氨基糖苷类药物仍为高敏。近年来ESBLs( )肺炎克雷伯菌和大肠埃希氏菌产生的比例增加,使临床用药越来越困难,亚胺培南等对此高度敏感。结论凝固酶阴性葡萄球菌感染为本地区新生儿败血症的主要致病菌。产ESBLs肺炎克雷伯菌和大肠埃希氏菌是目前本科的最主要耐药菌株,也是目前院感主要的常见菌。第3代头孢菌素的广泛使用、医护人员的手、器械、院内环境的传播可能是耐药菌株的产生的诱因。临床应予以重视与防范。     

77例肝衰竭患者医院感染败血症的临床研究

目的 探讨肝衰竭患者医院感染败血症的临床特征及预防措施。方法 回顾性分析在2001～2002年4月之间，住院患者中发生的医院感染败血症。结果 医院感染败血症发病率为0．61％，病死率为14．29％，感染原发病灶以自发性细菌性腹膜炎及泌尿系感染为最常见，占总数的71．40％。临床表现多有高热症状，体温高于39℃的患者共71例，占总数的92．20％，热型以不规则热为主。最常见病原菌为大肠埃希菌，大部分致病菌对常用的抗菌药物耐药性上升。结论 合理使用抗菌药物，重视细菌培养和药敏，加强预防措施，可以减少医院感染败血症情况的发生。     

Immunoglobulin-M estimation and C-reactive protein detection in neonatal septicemia

Immunoglobulin-M estimation, and C-Reactive Protein test and blood culture were performed on 57 neonates, clinically suspected to have septicemia. IgM level of > or = 20 mg/dl was found in 58.62% cases and CRP test was positive in 68.98% of culture proven sepsis. Blood culture was positive in 29 cases, with the predominant organism being Klebsiella. Of the 2 tests, CRP had a higher sensitivity (68.97%) while IgM estimation had a higher specificity (82.14%). When the 2 tests were considered together the sensitivity and specificity further increased. Death rate among neonates with IgM levels < 20 mg/dl was 5 times higher than those with elevated IgM levels.     

The effect of Helicobacter pylori eradication on C-reactive protein: results from a meta-analysis

IntroductionHelicobacter pylori is a bacterium that causes chronic gastroduodenal infection and affects various systemic diseases. An increase in the blood level of C-reactive protein (CRP; a systemic inflammatory marker), at a low-grade chronic inflammation level, is observed in cases of infection. However, the effect of H. pylori eradication on CRP remains undetermined. Therefore, we aimed to evaluate the circulating CRP levels in eradicated patients through a meta-analysis.Material and methodsThe PubMed database was searched from its inception to June 2020. Studies that described the CRP levels following H. pylori eradication were collected. A random-effects meta-analysis was then performed using inverse variance with standardized mean difference.ResultsA total of 10 eligible studies (642 subjects in total) were available. The median age in the studies was 49.9 years. The CRP level was 6.0 (median) mg/l before H. pylori eradication and 5.8 (median) mg/l after eradication. From the results of the overall meta-analysis, there was found to be a significant reduction in the CRP levels with H. pylori eradication (standardized mean difference: –0.64; 95% confidence interval: –1.02 to –0.27). The result was not similarly confirmed in a subanalysis of the available randomized controlled trials.ConclusionsWeak evidence exists regarding the effects of H. pylori eradication on CRP levels. Further research is called for.     

C-反应蛋白在动脉粥样硬化中的作用

C-反应蛋白（C-reactive protein,CRP）是反映炎症的敏感指标。近年的研究揭示超敏C-反应蛋白（high-sensitive CRP,hs-CRP）是心血管疾病的危险标志之一。同时还发现CRP自身可能直接参与了动脉继样硬化的过程,CRP可增加单核细胞向血管壁黏附、促进巨噬细胞摄取LDL,促使内皮细胞功能失调及促进平常细胞迁移和增生;CRP还与血栓形成和斑块的破裂有关。     

Not only immunoglobulins,C-reactive protein too

The purpose of this letter is to expand a discussion, published recently in Molecular Immunology, on the post-secretion gain of function by immunoglobulins. It was reported that some circulating IgG molecules in all healthy individuals acquire novel antigen-binding specificity after exposure to conditions that change protein conformation, such as acidic pH. Another protein, C-reactive protein, also acquires novel ligand-binding specificity post-secretion after a switch from its native pentameric conformation to non-native pentameric conformation. Thus, that the functions of a protein depend upon its alternate structural states, and therefore on the surrounding milieu, is a more general phenomenon for some ancient molecules of the immune system than previously thought.     

血清胱抑素C、超敏C反应蛋白表达水平对急性冠脉综合征的临床诊断价值

目的 探讨血清超敏C反应蛋白（hs-CRP）、胱抑素（Cys-C）表达水平对急性冠脉综合征（ACS）的临床诊断价值.方法 选取入住我院心内科134例ACS患者,其中稳定型心绞痛患者（SA）60例,不稳定型心绞痛患者（UAP）52例,急性心肌梗死（AMI）患者22例,同时健康体检者62例,测定各组hs-CRP、Cys-C l以及相关性因子的水平,并进行统计学分析.结果 ①ACS患者hs-CRP（mg/L）（SA组：4.87 ±0.65、UAP组：9.81 ±1.13、AMI组：20.27±2.36、对照组1.24±0.52）、Cys-C （mg/L）（SA组：0.76±0.13、UAP组：1.03±0.17、AMI组：1.39±0.36、对照组0.46±0.07、基质金属蛋白酶（MMP）-9（μg/mL）（SA组：308.43±35.52、UAP组：379.86±27.90、AMI组：420.13±50.16、对照组112.07±10.18）以及IL-6 （pg/L）（SA组：62.37±5.18、UAP组：69.05±7.18、AMI组：72.53±6.95、对照组27.19±3.96）表达水平明显升高,差异具有统计学意义（P＜0.05）,内皮细胞一氧化氮合酶（eNOS）（μmol/L）（SA组：22.84±2.65、UAP组：19.43±1.79、AMI组：7.93±1.17、对照组30.19±3.53）水平相对于对照组降低,差异有统计学意义（P＜0.05）;②ACS血清hs-CRP表达与Cys-C,MMP-9,eNOS相关（P＜0.05）,Cys-C与MMP-9、eNOS、IL-6表达具有相关性（P＜0.05）;③SA组、UAP组以及AMI组血清hs-CRP、Cys-C表达水平依次升高,差异具有统计学意义（P＜0.05）.结论 血清hs-CRP、Cys-C表达对于诊断ACS可能具有临床意义.     

Isolation of human C-reactive protein and serum amyloid P component

Procedures are described for the isolation in high yield of consistent, highly purified preparations of human C-reactive protein (CRP) and serum amyloid P component (SAP). CRP was obtained from malignant ascitic and pleural fluids by calcium-dependent affinity chromatography on pneumococcal C-polysaccharide covalently coupled to cyanogen bromide-activated Sepharose. It was then gel filtered on Ultrogel AcA44 (acrylamideagarose beads) in the presence of calcium ions, combining molecular sieve chromatography with removal of contaminating SAP by its affinity for agarose. Residual trace contaminants were removed by immunoabsorption with anti-normal human serum and anti-SAP antibodies insolubilised on Sepharose and/or by absorption with Sepharose-Con A to remove glycoproteins and Blue-Sepharose to remove albumin. After a final gel filtration step on Sephacryl S-300 35–44% of the initial CRP was recovered in pure from according to biochemical and immunochemical criteria. SAP was isolated from normal serum by calcium-dependent affinity chromatography on unsubstituted Sepharose beads, followed by solid-phase immunoabsorption of contaminants and finally gel filtration on Sephacryl S-300. At least 50% of the SAP in the starting material was recovered in pure form according to biochemical and immuunochemical criteria. Ready availability of such preparations facilitates biochemical, biophysical and particularly biological studies of these plasma proteins.