老年肺部感染患者C反应蛋白测定的临床意义

The Significance of C-RP in Aged Patients with Pneumonia

目的观察C反应蛋白测定对老年肺部感染患者的诊断和治疗方面的临床应用价值.方法采用免疫浊度散射速率法测定老年肺部感染患者治疗前后血C反应蛋白(C-reactive protein,CRP)浓度、并测定患者治疗前后血沉(erythrocyte sedimentation rate,ESR)、血白细胞总数(white blood cell,WBC)、中性粒细胞百分数(neutrophil,N)、体温(temperature,T)及痰培养,采用自身对照t检验和卡方检验进行统计学比较.结果患者入院时CRP均明显大于8mg/L,治疗后的CRP水平明显降低(P<0.01),且肺部感染患者的CRP的阳性率明显高于ESR、WBC、N、体温和痰培养(P<0.05).结论C反应蛋白(CRP)是一种由肝细胞合成的急性时相蛋白,机体发生感染时数小时内就可明显升高,在有效抗感染治疗后明显下降.由于CRP较ESR、WBC、N、体温和痰培养的检出更为敏感,因此,CRP可作为诊断老年肺部感染和观察疗效的敏感指标.

Objective The systematic reaction of the aged patients with pneumonia is poor, the chnical symptoms of pneumonia are untypical, so it is difficult to diagnose early. This research is to evaluate the clinical value of the C-RP in the diagnosis and treatment of the aged patients with pneumonia. Methods We detected the C-RP concentration of the aged patients with pneumonia, ESR, the total number of the white blood cells, neutrophil, temperature, sputum culture before and after treatment. The data were compared between before and after trentment. Results The C-RP levels were more than 8 mg/L when the patients were admitted, but decreased significantly after treatment （P 〈 0.01 ）. The positive rate of C-RP in the patients with pneumonia was higher than WBC, neutrophil, ERS, temperature, and sputum culture （P〈 0.05）. Conclusions C-RP is a instant reaction protein that is synthesized in liver cells. When there is infection in the body C-RP elevates in hours and it will decrease significantly after infection is controlled. Because it is more sensitive than ERS, WBC, neutrophil, temperature, sputum culture, C-RP can be as a sensitive index to diagnose patients with pneumonia and monitor the treatment.