271例甲型H1N1流感C-反应蛋白与白细胞的关系探讨

Relationship Between C-Reactive Protein and White Blood Cell in 271 Patients with Influenza A(H1N1)

目的:探讨甲型H1N1流感C-反应蛋白(CRP)与白细胞(WBC)的关系。方法:回顾性分析271例住院患者不同临床类型、不同疾病阶段CRP与WBC的关系。结果:①甲型H1N1流感患者感染初期CRP升高常见,且升高程度随着病情的加重而更明显。②轻症患者CRP升高幅度<3倍正常值上限(ULN),重症患者CRP升高幅度达10倍ULN,危重症患者CRP升高幅度达20倍ULN。③Pearson相关分析显示,感染初期CRP与年龄、WBC及中性粒细胞百分率(GR%)均呈正相关。当校正了年龄因素后,偏相关分析发现CRP仍与WBC呈正相关,与GR%的相关性消失。结论:甲型H1N1流感患者CRP升高常见,轻度升高(<3倍ULN)与病毒感染所致的炎症反应有关,明显升高(≥10倍ULN)提示合并细菌感染。

Objective：To analyze relationship between C -reactive protein （CRP） and white blood cell（ WBC ） in different clinical stage and different clinical severe degree influenza A （H1N1） cases confirmed in Sichuan. Methods： Retrospectively analysed 271 cases of Influenza A（ H1 N1 ）. Studied the relationship between CRP and WBC in different clinical stage and different clinical severe degree. Results：l ） CRP was elevated in earlier time in influenza A（ H1N1 ）, The elevated degree was as well as severity of disease. 2）. The elevated degree of CRP was mild and usually less than three times of upper line normal （ULN）. But ten times and twenty times of ULN in cases was with heavy clinical features. 3 ） Pearson correlation analyses showed that CRP was positively correlated with age , WBC and neutral granular cell percentage （ GR% ）. Adjusting for age, partial correlation analyses showed that CRP was still positively correlated with WBC, but there was no relation between CRP and GR%. Conclusion：CRP is usually elevated in earlier time in influenza A（ H1N1 ）. Mild elevation （less than three times of ULN） is viral infection and inflammation. Significant elevation（ no less than ten times of ULN） maybe infection with bacteria.