血清C反应蛋白水平在鉴别不同类型腹泻中的意义

Significance of C-reactive Protein as Detection Index in Patients with Diarrhea

目的:探讨急性腹泻患者C反应蛋白(CRP)的变化。方法:270例成人急性腹泻患者为观察组又分为轻度脱水组、中度脱水组及重度脱水组或细菌感染腹泻组、病毒感染腹泻组及非感染性腹泻组;行常规体检的健康成人80例作为对照组,所有受检者于入院时或体检当日采集空腹静脉血并分离血清,采用免疫比浊法检测患者血清CRP水平,计算CRP阳性率(血清CRP>10 mg/L),分析不同脱水程度及是否发生感染和感染类型对患者血清CRP水平的影响。结果:与对照组比较,不同程度脱水组或不同类型感染组患者血清CRP水平及阳性率明显升高,差异有统计学意义(P<0.05);重度脱水组与中度脱水组患者或非感染组组与病毒感染组患者的CRP水平及阳性率比较,差异无统计学意义(P>0.05);重度脱水组与中度脱水组患者的CRP水平及阳性率高于轻度脱水组,细菌感染组患者的CRP水平及阳性率高于非感染组组与病毒感染组,差异有统计学意义(P<0.05)。结论:中重度脱水腹泻患者或细菌感染性腹泻患者血清CRP水平升高明显,血清CRP水平可用于指导临床用药。

Objective： To explore the changes of c-reactive protein （CRP） in patients with acute di- arrhea. Methods： 270 cases of adult patients with acute diarrhea were divided into the observation group, including mild dehydration group, moderate dehydration group and severe dehydration group according to dehydration condition. Besides, they were also divided into the bacterial infection diarrhea group, virus infection diarrhea group and non infectious diarrhea group according to causes of infec- tion. 80 healthy adults undergoing normal physical examination were enrolled as control group. The fasting venous blood was collected and serum was separated in all subjects on the day of hospitalization or physical examination. Immune turbidity method was adopted to detect the serum CRP level, the pos- itive rate of CRP （ serum CRP 〉 10 mg/L） was calculated, and the effect of different degree of dehy- dration and the type of infection on the level of serum CRP in patients was analyzed. Results： Com- pared with the control group, the levels of serum CRP and the positive rate of different degree dehydra- tion group or different type infection group were significantly increased, and the difference was statisti- cally significant （P 〈 0.05 ）. There was no statistically significant difference in the level of CRP and the positive rate between the severe dehydration group and the moderate dehydration group or between the non infectious group and the virus infection group （ P 〉 0.05 ）. The CRP level and the positive rate in the severe dehydration group and moderate dehydration group was higher than that of the mild dehy- dration group, while the CRP level and the positive rate in bacterial infection group was higher than those of the non infectious group and virus infection group, and the difference was statistically signifi- cant （P 〈 0.05 ）. Conclusion ： The level of serum CRP was significantly increased in patients with moderate or severe diarrhea and bacterial infections, and the serum CRP level can be used to guide clinical drug use.