C-反应蛋白在骨髓移植后并发症早期诊断及疗效评估中的应用价值

目的探讨C-反应蛋白(CRP)在骨髓移植后患者临床并发症诊断及疗效评估中的价值。方法选取北京大学人民医院血液病研究所2004—2005年骨髓移植后出现不同并发症的患者66例,在不同时间点进行CRP定量检测,分析不同CRP值与所对应的并发症的关系。结果骨髓移植后不同并发症患者中,其CRP是否升高及升高程度明显不同,在细菌感染、合并细菌感染的混合感染、超急性移植物抗宿主病(GVHD)及抗胸腺细胞球蛋白(ATG)反应中可出现CRP明显升高,细菌感染、真菌感染、细菌合并病毒感染、急慢性GVHD等并发症均可出现CRP轻度升高,而单纯病毒感染CRP不升高。在细菌感染临床症状最明显时,CRP可达最高;治疗有效者CRP逐渐降低;CRP恢复正常后又出现增高者,临床上出现新并发症。结论CRP在骨髓移植后患者并发症的早期鉴别诊断及治疗效果的评估中有一定的应用价值。

Study on the value of the diagnosis and efficacy evaluation of c-reactive protein (CRP) test in patients clinical complications after bone marrow transplantation

Objective To study the value of c-reactive protein (CRP) level in the diagnosis and efficacy evaluation of clinical complications in patients after bone marrow transplantation.Methods Sixty-six patients with different complications after bone marrow transplantation were included and CRP levels were tested.The relationship between CRP levels and corresponding clinical complications were analyzed.Results The levels of CRP were significantly different in different complications after the bone marrow transplantation.CRP may marketly increase in the patients with bacterial infection,bacteria-associated mixed infection,ultra-acute GVHD,and ATG reaction;CRP may mildly increase in patients with bacterial infection,fungal infection,bacteria-associated mixed infection,acute/chronic GVHD;CRP did not increase in the patients with viral infection.CRP level reached the highest value in patients with most obvious clinical symptoms of bacterial infection,gradually decreased in patients after effective treatment,those restored to normal but then increased CRP always indicated new clinical complications.Conclusion CRP is a valuable mark for the early differential diagnosis and efficacy of therapy for complications in patients after bone marrow transplantation.