超敏C反应蛋白在感染性疾病病情预测的应用：116例伴或不伴脓毒症的肺炎患者分析

Value of high sensitive C-reactive protein in prediction of scope and severity of inflammation： study of 116 pneumonia patients with or without sepsis

目的探讨超敏C反应蛋白（hs—CRP）在感染性疾病时病情预后判断的意义。方法78名单纯性肺炎患者、28名肺炎合并轻度脓毒症患者和10名肺炎合并组和重度脓毒血症患者（均60岁左右）接受体格检查、X-线摄片和白细胞和中性粒细胞计数，用乳胶增强免疫比浊法检测血清hs—CRP。结果单纯性肺炎组的中性粒细胞计数和均数均显著低于轻度和重度脓毒症组（均P〈0．01），而轻度脓毒症组与重度脓毒症组间发差异无显著性（均P〉0．05）。单纯性肺炎组的hs—CRP值和均数显著低于轻度和重度脓毒症组（均P〈0．01），轻度脓毒症组的hs—CRP值和均数亦显著低于重度脓毒症组（均P〈0．01）。单肺叶病变组57例，多肺叶病变组69例。肺炎单叶组与肺炎双叶组间，中性粒细胞计数、hs—CRP值的差异均无显著性（均P〉0．05）。结论hs—CRP是反映感染的范围和严重程度有价值的诊断指标。

Objective To investigate the significance of high sensitive C-reactive protein （hs-CRP） in prediction of the severity of infectious diseases. Methods 78 patients of pneumonia, 28 patients of pneumonia combined with mild sepsis, and 10 patients of pneumonia combined with severe sepsis, all around the age of 60, underwent physical examination, X-ray photography, and neutrophil count. Latex enhancement immunity nephelometery was used to measure the serum hs-CRP. Results The neutrophil number and mean of the pure pneumonia group were significantly lower than those of the mild and severe sepsis groups （all P 〈0.01）, and there were not significant differences in the neutrophil number and mean between these 2 sepsis groups （both P 〉0.05）. The hs-CRP value and mean of hs-CRP of the pure pneumonia group were both significantly lower then those of the 2 sepsis groups （all P 〈0.01）, and those of the mild sepsis group were significantly lower than those of the severe sepsis group too （both P〈0.01）. X-ray photography showed 57 patients with inflammation in only one pulmonary lobe, and 69 patients with inflammation in multiple lobes. There were not significant differences in the neutrophil count and hs-CPR values between the mono-lobular group and multi-lobular groups （P〉0.05）. Conclusion hs-CRP is a valuable to predict the scope and severity of inflammation.