全身炎症反应综合征患者血浆C-反应蛋白变化与内毒素水平关系的研究

Study on the relationship between plasma C - reactive protein and endotoxin in the patients with systemic inflammatory response syndrome

目的 研究全身炎症反应综合征（SIRS）患者急性期反应及血浆C-反应蛋白（CRP）合成调控与内毒素浓度的关系.方法 符合SIRS诊断标准的32例患者于入院后2 h内,第2、3和5天清晨空腹抽取肘静脉血3 mL,应用速率散射免疫比浊法测定CRP和基质偶氮显色鲎试验测定法测定内毒素浓度,并设健康对照组.结果血浆CRP水平和内毒素浓度在入院后2 h即显著升高,第2天达高峰,各时相点均明显增加,与对照组比较差异有统计学意义（P＜0.01）;血浆CRP水平与内毒素浓度呈显著正相关（r=8.9632,P＜0.01）;器官功能不全组患者血浆CRP水平与内毒素浓度显著高于器官功能正常组患者（P＜0.05）.结论 SIRS患者急性期反应显著增强,内毒素具有直接或间接调节CRP合成的作用,因此,防止外源性和内源性内毒素血症、控制血浆CRP水平是治疗SIRS、预防MODS的有效措施.

Objective To analyze the acute phase response of patients with systemic inflammatory response syndrome （SIRS）, and the relationship between plasma C -reactive protein （CRP） and endotoxin. Methods 32 patients diagnosed as SIRS were in the trial group, while health people were in control group. 3 mL blood was drawn from elbow vein in each patient respectively within 2 hours, on the 2nd, 3rd and 5th days＇ mornings after admissions. CRP was assayed by turbidimetry and endotoxin was checked by chromogenion limulus amebocyte lysate. Results Plasma CRP and endotoxin began to rise obviously within 2 hours and reached the peak on the 2rid day. They kept the high levels during the observation period and were significant different from the control group （ P 〈 0. 01 ）. There was a significantly positive correlation between CPR and endotoxin （ r = 8. 9632, P 〈 0.01 ）. In addition, they were higher in the organ dysfunction group than those in normal organ function group （P 〈 0. 05 ）. Conclusion The acute phase response was enhanced obviously in SIRS patients, and endotoxin might regulate the CPR synthesis directly or indirectly. So the prevention from extrinsic ＆ intrinsic endotoxemia and the domination of CPR level were effective measures to treat SIRS and prevent multiple organ dysfunction syndrome （MODS）.