C-反应蛋白测定在重症监护病房患者中的临床应用

Clinical application of C-reaction protein assessment in ICU patients

目的评价C反应蛋白(CRP)对ICU感染及炎症反应患者的临床应用价值。方法前瞻性研究,共有100例ICU患者入选,其中全身炎症反应综合征(SIRS)组52例和多器官功能障碍综合征(MODS)组48例;感染组68例和非感染组32例及经治疗后好转组70例和恶化组30例,分别测定血中CRP水平并观察比较各组数值变化。结果MODS组比SIRS组的CRP明显升高(P<0.05)。而感染组和非感染组CRP无差异(P>0.05)。治疗前后比较,CRP在好转组治疗后明显减低,而恶化组治疗后数值升高(P<0.05)。结论CRP对ICU患者感染诊断的特异性较差,但与炎症反应严重程度有一定关系,且对治疗效果及预后判断有一定指导意义。

Objective To comment on the value of clinical application of using C-reaction protein(CRP) in ICU patients with infection and inflammatory reaction.Methods A perspective study was adopted with 100 ICU patients selected altogether,who were again observed in terms of the following three states:the first group which included 52 patients of systemic inflammatory reaction syndrome(SIRS) and 48 of multiple organ-functional defect syndrome(MODS);The second state in which 60 cases fell into the infectious group and 32 cases in the non-infectious group,and the third state which included 70 cases showing improvement post-therapeutically while 30 cases showing post-therapeutic deterioration.In all these cases,plasma CRP levels were assessed separately and their respective variation of their values in each group was observed and compared.Results There was an apparent increase of CRP in the cases of the MODS group as compared with cases in the SIRS group with significant difference(P<0.05).However,a comparison of CRP in the cases of the infectious and non-infectious groups showed no significant difference(P>0.05).CRP in the cases of the group with post-therapeutic improvement was significantly lowered while that in the cases of the deteriorated group the post-therapeutic value was elevated,statistical difference was significant(P<0.05).Conclusion It is apparent that CRP possesses a poor specificity in making diagnosis for infection in the ICU patients,but it possesses a definite relationship to the extent of severity of their inflammatory reactions.And also it possesses a certain degree of instructive significance to the therapeutic effects as well as the judgment of prognosis.