D-二聚体及C-反应蛋白与不同肺部疾病的关系

Correlation between C-reactive protein and D-dimer levels and lung disease

目的探讨D-二聚体(D-D)和C-反应蛋白(CRP)在肺炎、肺结核(TB)、潜伏性结核感染(LTI)、重症肺结核、肺癌患者及健康人群中的水平差异及临床意义。方法比较44例肺炎患者、41例肺结核、30例潜伏性结核感染、27例重症肺结核、42例肺癌患者和健康对照组49名的D-D及CRP含量,并进行相关分析。结果血浆D-D含量水平:重症肺结核组最高,为(0.577±0.488)mg/L,肺癌、肺结核及肺炎次之,分别为(0.338±0.326)、(0.324±0.278)、(0.320±0.233)mg/L,潜伏性结核感染与健康对照组含量最低,为(0.283±0.262)、(0.180±0.154)mg/L;血清CRP水平:重症肺结核组及肺炎最高,为(108.67±68.94)、(75.91±77.83)mg/L,肺结核及肺癌次之,分别为(53.42±58.91)、(39.61±43.80)mg/L,潜伏性结核感染与健康对照组含量最低,为(25.03±21.42)、(13.03±9.69)mg/L;血浆D-D与血清CRP含量变化存在相关性,肺炎组r=0.463,肺结核组r=0.325,重症肺结核组r=0.178,健康对照组r=0.143,肺癌组r=0.121,潜伏性结核感染组r=0.076,均P<0.05;肺癌死亡组第1天及观察终点D-D、CRP水平均高于正常组。结论 D-D及CRP水平与疾病严重程度及感染相关炎症分级密切相关,可作为判断病情及评估预后的指标。

OBJECTIVE To explore the clinical significance and compare the difference of D-dimer（D-D） and C-reactive protein（CRP） levels in patients with pulmonary infections,active pulmonary tuberculosis（TB）,latent tuberculosis infection（LTI）,severe pulmonary tuberculosis,lung cancer and healthy subjects.METHODS Our study was designed to evaluate D-D,and CRP levels in 44 pneumonia cases,41 active pulmonary tuberculosis（TB） cases,30 LTI cases,27 severe pulmonary tuberculosis cases,42 lung cancer cases and 49 healthy subjects,then the correlation was statistically analyzed.RESULTS D-D levels was found to be the highest in the cases with severe pulmonary tuberculosis（0.577±0.488 mg/L）,followed by the lung cancer,active pulmonary tuberculosis and pulmonary infection（0.338±0.326 mg/L,0.324±0.278 mg/L and 0.320±0.233 mg/L）,and latent tuberculosis infection and healthy people（0.283±0.262 mg/L and 0.180±0.154 mg/L）;CRP levels was found to be significantly higher in cases with severe pulmonary tuberculosis and pulmonary infection（108.67±68.94 mg/L and 75.91±77.83 mg/L）,followed by the pulmonary tuberculosis and the lug cancer（53.42±58.91）,（39.61±43.80）mg/L,the latent tuberculosis infection and healthy people（25.03±21.42 mg/L and 13.03±9.69 mg/L） were the lowest;there was a correlation between the level of D-D and level of CRP,r=0.463 of the pulmonary infection group,r=0.325 of active pulmonary tuberculosis group,r=0.178 of severe pulmonary tuberculosis,r=0.143 of healthy people group,r=0.121 of lung cancer group,and r=0.076 of latent tuberculosis infection group（P0.05）.both of the D-D and CRP levels of the lung caner group were higher than the control group on the first and final of the observation.CONCLUSION The increasing of D-D and CRP levels are found to be correlated with the severity of the diseases and the infections,which can serve as indicators for the condition judgment and the evaluation of prognosis.