队列研究C-反应蛋白在活动性结核病患者全疗程中的变化情况

Cohort study on the change of CRP in active TB patients treatment course

目的通过前瞻性纵向研究,探讨活动性肺结核患者C-反应蛋白(CRP)、体质量指数(BMI)、糖化血红蛋白(Hb A1c)、中性粒细胞比例(NEU)水平变化的特点,并分析这些指标在菌阳肺结核、菌阴肺结核及肺外结核和健康对照者中的转归变化情况,寻找疗效评价指标。方法收集河南省胸科医院2010年3月-2012年3月收治的新发结核患者150例和健康志愿者45例,分别在0周、2周、4周、6周、8周、16周、24周进行痰标本的收集,并进行64排CT的检查,建立标本库,并进行队列检查分析。结果 3组活动性肺结核患者的CRP水平均高于健康人群,并随着治疗而快速下降、痰培养阴转时间越短,CRP的下降速度越快。BMI、Hb A1c、NEU 3项指标变化不大。结论 CRP测定结果可为临床上评价活动性肺结核治疗效果提供依据,为医生修改治疗方案提供参考。

Objective To investigate the changes of C-reactive protein（CRP）,body mass index（BMI）,glycosylated hemoglobin（Hb A1 c） and neutrophils ratio（NEU） in active pulmonary tuberculosis patients,and to analyze the changes of these indexes in bacteria positive pulmonary tuberculosis,Mycobacterium tuberculosis and extrapulmonary tuberculosis and controls. The prognosis of patients in the control group was evaluated. Methods 150 new tuberculosis patients and 45 healthy volunteers were collected from March 2010 to March 2012 in Henan Thoracic Hospital. The samples were collected at 0 w,2 w,4 w,6 w,8 w,16 w and 24 w for 64 rows of CT examination,the standard library was built,and the cohort examination was carried out.Results The CRP levels of the three groups of active pulmonary tuberculosis were higher than that of the healthy people and decreased with the treatment. The shorter sputum culture time was,the faster CRP decreased. The body mass index（BMI）,glycosylated hemoglobin（Hb A1 c） and neutrophil proportion（NEU） changed little. Conclusion The results of CRP can provide basis for clinical evaluation of the therapeutic effect of active pulmonary tuberculosis and also provide reference for doctors to modify the treatment regimen.