三种急性时相蛋白在急性上呼吸道感染诊治中的价值

目的:探讨急性时相蛋白(APP)在上呼吸道感染诊断和治疗过程中的变化规律及应用价值。方法:采用速率散射比浊法对104例上呼吸道感染患者在诊断和治过程中C-反应蛋白(CRP)、血清淀粉样蛋白A(SAA)、α1-酸性糖蛋白(AAG)进行检测。结果:细菌感染患者三种急性时相蛋白浓度显著高于正常对照组(P<0.01),其中,以革兰阴性菌感染APP升高最为显著,革兰阳性菌次之,真菌感染升幅最低;病毒组APP中SAA较正常对照明显升高(P<0.01),其余二项无显著增高(P>0.05);细菌组与病毒组比较:CRP、AAG两项指标显著高于病毒组(P<0.05);SAA浓度均大幅升高,病毒组高于细菌组(P<0.05);两组患者治疗有效者APP(病毒组SAA)第3天已有下降,7d明显下降(P<0.01),至21d恢复至对照组水平(P>0.05),而预后不良的患者血中APP的浓度仍维持较高水平。结论:监测急性时相蛋白对上呼吸道感染的诊断、疗效观察和预后评估以及鉴别诊断均有较大价值。

The Value of Three Acute Phase Proteins in Diagnosis and Treatment of Acute Upper Respiratory Infection

Objective:To discuss the change and applicated significance of acute phase protein(APP) in diagnosis and treatment of acute upper respiratory infection.Methods:Acute phase proteins including C-reactive proteins(CRP),serum amyloid A protein(SAA) and alphal-acid glycoprotein(AAG) of 104 patients with acute upper respiratory infection were detected by rate nephelometry during diagnosis and treatment.Results:Density of three APP were significantly higher in patients with bacterial infection than those in normal controls(P<0.01).Among the total,the level of APP in patients with infection of Gram-negative bacteria increased most significant,that of Gram-positive bacteria increased lower and Fungus bacteria was the lowest.The level of SAA in viral group were significantly higher than control group(P<0.01),the level of CRP and AAG had no significant increment(P>0.05).Contrast to viral group,the level of CRP and AAG in bacterial group increased more significant(P<0.05);Density of SAA in both group increased dramaticly,and it was more significant in viral group than bacterial group(P<0.05).APP(SAA of viral group)of responder in both group began to decrease three days after treatment,decreased significantly after a week(P<0.01),and roughly equaled with normal group after three weeks(P>0.05),but the density of APP in patients of prognosis mala was still on high level.Conclusion:Monitoring CRP levels is valuable in diagnosis of acute upper respiratory infection,observation of therapeutic effect,evaluation of prognosis,and antidiastole.