血清淀粉样蛋白A和C反应蛋白在相关炎性疾病监测中的应用

The Application of Serum Amyloid A and C-reactive Protein in Monitoring of Inflammatory Diseases

目的探讨急性时相反应蛋白血清淀粉样蛋白A(SAA)和C反应蛋白(CRP)在相关炎性疾病监测中的应用价值。方法选择2016年1月1日~10月31日于湖北省谷城县人民医院临床疑似有感染的住院患者1020例以及111例健康体检患者(正常对照组),对其进行CRP和SAA检测。将住院患者按照疾病类型分为6组:糖尿病伴并发症、心血管疾病、多发性骨髓瘤、创伤骨折、其他肿瘤和皮肤疾病。分别对每组疾病的SAA、CRP实验数据做ROC曲线面积分析,判断二者单独检测和平行试验联合检测对各种疾病的诊断价值。结果通过对实验数据进行分析,SAA与CRP变化趋势不一致的患者占44.6%,所占比例较大,尤以SAA增高而CRP正常患者居多。再比较这两种指标在同一种疾病中的升高幅度,前者高于后者。通过对各种疾病的ROC曲线下面积计算,可得联合检测一般具有更多的曲线下面积。结论 SAA相比于CRP,在相关炎性疾病监测中可能更有临床价值。临床上在进行炎症监测时,应重视SAA异常升高而CRP正常患者。在有条件的情况下选择两种指标做联合检测,更具有临床诊断价值。

Objective To investigate the application value of acute phase reactants serum amyloid A （SAA） and C-reactive protein （CRP） in the monitoring of inflammatory diseases. Methods Datas of SAA and CRP of 1020 cases of patients with clinically suspected infection as experimental group and 111 healthy subjects as normal control group were collected and analyzed. Experimental group was divided into 6 groups according to the types of disease： diabetes mellitus （DM） with complication, cardiovascular diseases, multiple myeloma, traumatic fractures, other tumors and skin diseases. The SAA and CRP experimental data of each group were analyzed by ROC curve area, and the diagnostic value of two independent tests and parallel tests for each disease was determined. Results The analysis of experimental data showed that, SAA and CRP changes in the trend of inconsistent patients accounted for 44.6%, the proportion was relatively large, especially SAA increased, while CRP patients were normal. Compared the two indicators in the same disease in the increase, the former was higher than the latter, and through the experimental data calculated SAA compared to CRP higher sensitivity to the disease. By calculating the area under the ROC curve of various diseases, it could be found that joint detection generally had more area under the curve.Conclusion Compared with CRP, SAA may be more clinically valuable in monitoring inflammatory diseases. In clinical practice, attention should be paid to abnormal elevated SAA levels in patients with normal CRP. Choosing two kinds of indexes for joint detection under conditioned circumstance is more valuable in clinical diagnosis