免疫荧光法检测C-反应蛋白的临床应用分析

Analysis of clinical application of immunofluorescence detecting C-reactive protein

目的探讨免疫荧光法检测血清C-反应蛋白在感染性疾病和心血管疾病等诸多疾病中的临床应用。方法采用免疫荧光法检测血清中C-反应蛋白包括超敏C-反应蛋白(hs-CRP)和常规C-反应蛋白(cRP)。结果在婴幼儿感染性疾病中细菌性炎症(化脓性脑膜炎、败血症、脓肿、脐炎)CRP>25mg/L和hs-CRP>3.0mg/L者分别占77.3%和95.5%,两组构成比均高于病毒感染多见的疾病(肺炎、支气管肺炎、上呼吸道感染、小儿肠炎)的6.2%、27.4%和病毒感染性疾病(手足口病、CNS病毒感染)的0.0%、51.6%,差异有统计学意义(P<0.05)。其它(消化道出血、窒息、早产、湿肺)非感染性疾病则以CRP<10mg/L、hs-CRP<1.0mg/L为主,分别占98.7%和83.1%。婴幼儿CRP<25mg/L、hs-CRP<1.0mg/L时,细菌培养阳性组与病毒感染组分布比例接近,差异无统计学意义(P>0.05);CRP<25mg/L、hs-CRP>3.0mg/L时,细菌培养阳性组分布比例为22.9%,低于病毒感染组的51.6%,差异有统计学意义(P<0.01);CRP>25mg/L、hs-CRP>3.0mg/L时则细菌培养阳性组分布比例高于病毒感染组,差异有统计学意义(P<0.05)。成人感染性疾病中CRP>50mg/L者,发热占77.8%,肺炎占68.7%,支气管肺炎占13.3%;外伤、直肠癌、产后出血等分别占78.6%、75.0%、69.2%。心血管疾病hs-CRP>3.0mg/L者占47.2%,hs-CRP 1.0～3.0 mg/L者占33.3%, hs-CRP<1.0mg/L者占19.5%。结论免疫荧光法定量检测CRP、hs-CRP临床应用广泛,特别是对幼儿、成人感染性疾病的诊疗及心血管疾病危险评级等有重要参考价值,是灵敏的实验室指标。

Objective To discuss the clinical application of immunofluorescence dectection of serum C- reative protein in infectious diseases, cardiovascular diseases and other sorts of diseases. Methods The immunofluo- rescence method adopted was in detecting C-reative protein in blood serum including hypersensitivity C-reative protein （hs-CRP） and normal C-reative protein （CRP）. Results In the infectious diseases in infants, when CRP 〉 25 mg/L and hs-CRP 〉 3. 0 mg/L the proportion of bacterial inflammation （ pundent meningitis, septicemia, abscess, omphal- iris） were separately 77.3% and 95.5%. The proportion of the two groups was higher than those of common viral in- fection diseases （pneumonia, bronchopneumonia, upper respiratory tract infection, children enteritis） （6.2%, 27.4% ,respectively） and those of virus-infected diseases （ hand-food-mouth disease, CNS virus infection） （ 0.0% , 51.6% , respectively） , （P 〈0. 05） ; tile difference had significance in statistics. Other non-ird＇ectious diseases （such as bleeding of the gastro intestinal tract, asphyxia, premature birth, pulmonary edema） were mainly CRP 〈 10 rag/L, hs-CRP 〈 1.0 mg/L with the proportion of 98.7% and 83. I% separately. When the infants＇ CRP 〈 25 mg/L and hs-CRP 〈 1.0 mg/L, the positive group of bacteria culture and the group of virus infection were close in proportion and the difference had no significance in statistics （P 〉 0. 05） ; when CRP 〈 25 mg/L and hs-CRP 〉 3.0mg/L, the group of bacteria culture had the distribution proportion of 22.9% lower than that in the group of virus infection （ 51.6% ） ,the difference had significance in statistics（P 〈0.01 ）. When CRP 〉25 mg/L and hs-CRP 〉 3.0 nag/L, the distribution proportion of the positive group of bacteria culture was higher than the virus infection, the difference had significance in statistics （P 〈0.05）. For adults with infectious diseases, when CRP 〉 50 mg/L, the access of fever accounted for 77.8% , pneumonia accounted for 68.7% and bronchopneumonia accounted for 13.3%. Trauma, rectum cancer and postpartum hemorrhage accotmted for 78.6% , 75.0% , and 69.2% separately. For cardiovascular diseases, when hs-CRP 〉 3.0mg/L, the proportion was 47. 2% , when hs-CRP ranged from 1.0 mg/L to 3.0 mg/L, the proportion was 33.3%, and when hs-CRP 〈 1.0 mg/L, the proportion was 19.5%. Conclusion Clinical application of immunofluorescence dectection of CRP and hs-CRP is extensive, especially for the diagnosis and treatment of infant＇ s and adult＇ s infectious diseases, and had significant reference value in valuating the dangerous level of cardiovascular diseases, which is sensitive laboratory guideline.