Distribution of High-sensitivity C-reactive Protein Status in an Urban Population in China

Objectives To evaluate the distribution by age and sex of serum high-sensitivity C-reactive protein(hsCRP)in an urban Chinese population and to provide a profile prediction for the risk of bacterial infection,inflammatory diseases,or tissue damages in the body.Methods Serum hsCRP was determined using the Roche Tina-quant immuno-turbidimetric assay on a Hitachi 7600–010 automatic biochemical analyzer(Roche Diagnostics)in 1,572 males and 1,800 females,including 78 pregnant women,who were derived from the National Health and Nutrition Survey in2010–2012.Results The average hsCRP concentration in urban China was 0.68 mg/L for males and 0.65 mg/L for females.Significant differences in hsCRP were found among different age groups(P<0.05).Monitoring results showed no significant differences among the 6–11,45–59,and≥60-year-old groups in the comparison of hsCRP between males and females in large cities.However,hsCRP concentration was significantly higher in men aged 12–17 and 18–44 years than in women.Conclusion The distribution of the hsCRP status of residents in large cities in China was influenced by age and gender,and the hsCRP levels of both sexes increased gradually with age.In addition,hsCRP concentration was higher in healthy pregnant women than in non-pregnant women.Basing on our results,we recommend that this parameter be included in future national and international screening for early detection of various illnesses.

Elevated levels of inflammatory cytokines and high-sensitivity C-reactive protein in periodontitis patients in Kosovo: A pilot study

The following article has been retracted due to the investigation of complaints received against it. The Editorial Board found that the same contents have been published in another journal at the same time. The scientific community takes a very strong view on this matter, and the Open Journal of Stomatology treats all unethical behavior such as plagiarism seriously. This paper published in Vol.3 No.1 32-38, 2013 has been removed from this site. Title: Elevated levels of inflammatory cytokines and high-sensitivity C-reactive protein in periodontitis patients in Kosovo: A pilot study Authors: Zana Sllamniku-Dalipi, Hasan Mehmeti, Fatmir Dragidella, Ferit Kocani, Metush Disha, Kastriot Meqa, Luljeta Begolli, Gramos

Responses of serum inflammatory factor high-sensitivity C-reactive protein, interleukin-6, and tumor necrosis factor-alpha in elderly males with cerebral infarction Non-randomized concurrent control

BACKGROUND： Cerebral infarction is poorly treated due to neuronal necrosis and secondary pathophysiological changes; for example, free radical production and inflammatory reactions. OBJECTIVE： To detect the levels of high-sensitivity C-reactive protein （hs-CRP）, interleukin-6 （IL-6）, and tumor necrosis factor- a （TNF- α ） in elderly males with cerebral infarction. DESIGN： Non-randomized current control study. SETTING： Cadre Medical Department, Guizhou Provincial People＇s Hospital. PARTICIPANTS： Forty elderly males （65-89 years old） with cerebral infarction were selected from Cadre Medical Department, Guizhou Provincial People＇s Hospital from February 2004 to December 2006. All patients met the diagnostic criteria of cerebral infarction modified at the 4th National Cerebrovascular Disease Academic Meeting, and were diagnosed on the basis of CT or MRI tests. Furthermore, 35 elderly male inpatients （65-87 years old） without cerebral infarction were selected as the control group. Included subjects provided confirmed consent and did not have heart disease, diabetes mellitus, lipid disorder, acute trauma, infection, rheumatism, or other inflammatory diseases. The study was approved by the local ethics committee. There were no significant differences in age, blood pressure, and lipid levels between the cerebral infarction group and the control group （P 〉 0.05）, and this suggested that the baseline data of both groups were comparable. METHODS： Fasting venous blood was drawn from cerebral infarction patients 24 hours after cerebral infarction attack and from control subjects 24 hours after hospitalization. A latex-enhanced immunoturbidimetric assay and an enzyme-linked immunosorbent assay were used to detect the levels of hs-CRP, IL-6, and TNF- α in the serum. MAIN OUTCOME MEASURES： The levels of hs-CRP, 1L-6, and TNF- α in the serum in both groups. RESULTS： Forty cerebral infarction patients and thirty-five control subjects were included in the final analysis without any loss. Levels of hs-CRP, IL-6, and TNF-α in the cerebral infarction group were significantly higher than those in the control group （P 〈 0.01 ）. CONCLUSION： Levels of serum inflammatory reactive factors are increased in elderly males with cerebral infarction.

N-terminal pro-brain natriuretic peptide but not high-sensitivity C-reactive protein is related to severity of coronary artery stenosis in patients with acute coronary syndrome

Objective Biochemical indicators such as N-terminal pro-brain type natriuretic peptide（NT pro-BNP）and high-sensitivity Creactive protein（hsCRP）predict mortality in acute coronary syndrome（ACS）.However,little is known about the relationship of these factors with severity of coronary artery stenosis in patients with.Methods Three hundred and thirty-one subjects including 246 unstable angina pectoris patients and 85 myocardial infarction patients were recruited and classified into two groups：single-vessel disease group（1-vessel disease,n=93）and multiple-vessel disease group（≥2-vessels disease,n=238）according to selective coronary angiography.Plasma levels of NT pro-BNP and hsCRP were measured and severity of coronary stenosis was determined by Gensini score.Results NT pro-BNP but not hsCRP level was higher in patients with myocardial infarction than in patients with unstable angina pectoris.The patients with multiple-vessel disease had significantly higher NT pro-BNP level but not hsCRP compared with those with single-vessel disease.NT pro-BNP levels increased significantly as left ventricle（LV）function decreased,and only NT proBNP but not hsCRP level was related to Gensini score of severity of coronary stenosis in ACS.Conclusion NT proBNP but not hsCRP level is related to severity of coronary artery stenosis in patients in ACS.

Value of N-Terminal Pro B-Type Natriuretic Peptide,High-Sensitivity C-Reactive Protein,and Homocysteine Levels in Predicting Cardiovascular Events in Chronic Heart Failure Patients After Discharge

Objective:To investigate the value of N-terminal pro B-type natriuretic peptide(NT-proBNP),high-sensitivity C-reactive protein(hs-CRP),and homocysteine(Hcy)levels in predicting cardiovascular events(CV)in patients with chronic heart failure(CHF).Methods:A total of 63 patients with CHF admitted to our hospital between June 2019 and July 2021 were selected.Their NT-proBNP,hs-CRP,and Hcy levels were detected at discharge,and a 12-month follow-up was done after their discharge to collect clinical data.The collected data were inclusive of data from 21 CHF patients with cardiovascular disease and 42 CHF patients without cardiovascular disease.The effect of NT-proBNP,hs-CRP,and Hcy levels on the occurrence of CV was analyzed.Results:The levels of NT-proBNP,hs-CRP,and Hcy in the group with cardiovascular disease were significantly higher than those in the group without cardiovascular disease(P<0.05);the levels of serum NT-proBNP,hs-CRP,and Hcy at discharge had certain value in predicting short-term CV in CHF patients(P<0.05).Conclusion:NT-proBNP,hs-CRP,and Hcy levels can be used to predict CV in CHF patients,thus having clinical application value.

The diagnostic value of tumor abnormal protein and high sensitivity C reactive protein in screening for endometrial cancer with endometrial thickness less than 8 mm

Objective This study aimed to combine tumor abnormal protein(TAP) and high-sensitivity C-reactive protein(hs-CRP) level detection to diagnose endometrial cancer in patients with endometrial thickness less than 8 mm, and to provide a reference for clinical screening and diagnosis. Methods Clinical data from 19 cases of endometrial cancer, diagnosed on the basis of pathological findings, were collected from September 2014 to December 2015. The inclusion criteria were as follows: the patients were first diagnosed with endometrial thickness less than 8 mm and were all in menopause. Perimenopausal patients(n = 26) with uterine fibroids seen during the same period were selected as a control group. Serum TAP and hs-CRP levels of the patients in the two groups were simultaneously determined on admission. Results We found that both TAP and hs-CRP levels in the experimental group were higher than those in the control group [(182.95 ± 72.14) μm^2 vs.(133.19 ± 55.18) μm^2, P = 0.019;(7.52 ± 19.03) mg/L vs.(1.66 ± 2.31) mg/L, P = 0.136]. The sensitivity of TAP for the diagnosis of endometrial cancer was 73.68%, the specificity was 69.23%, and the Youden index was 0.4291. The diagnostic sensitivity and specificity of hs-CRP was 15.79% and 100%, respectively, and the Youden index was 0.1579. After plotting the receiver operating characteristics curves, the optimal cut-off value for TAP in diagnosing endometrial cancer was found to be 160.662 μm^2 and that for hs-CRP was 1.07 mg/L. Conclusion For patients suspected of having endometrial cancer with endometrial thickness less than 8 mm, combined detection of TAP and hs-CRP levels can be used as a screening tool and can provide new ideas regarding clinical diagnosis and treatment.

High Sensitivity C-Reactive Protein Associated with Different Health Predictors in Middle-Aged and oldest old Chinese

Objective To describe the distribution of plasma high sensitivity C-reactive protein （hsCRP） and explore the relationship between hsCRP and metabolic risk factors among residents living in longevity areas of China. Methods 268 individuals aged between 40 and 59 years and 506 individuals aged over 90 years were selected from 5 longevity areas of China to participate in a cross section longitudinal cohort study. The participants were interviewed with general health related questionnaire to collect their demographic, behavioral and lifestyle data, as well as their chronic conditions, and meanwhile their physical and biomedical parameters including waist circumference （WC）, blood pressure （BP）, hsCRP, plasma lipids, and fasting blood glucose （FBG） were measured. Results The median of hsCRP was 0.99 mg/L in the middle-aged group and 2.76 mg/L in the oldest old group. No significant gender difference was observed between the above two groups. Among the oldest old individuals, 36.56% had an hsCRP level 〉3.0 mg/L. The prevalence of high hsCRP was 26.79% in the middle-aged group. The results of stepwise multiple linear regression analyses showed that HDL-C was independently associated with In （hsCRP） concentration in the middle-aged group, whereas In （TG）, HDL-C and FBG were correlated after adjustment for gender, study site, smoking, drinking, education and BMI in the oldest old group. Conclusion HDL-C is a stronger predictor of elevated hsCRP than other metabolic factors in the middle-aged population. For the oldest old persons, high TG, low HDL-C, and FBG predict elevated plasma hsCRP.

冠状动脉Z值等四联指标模型对黏膜皮肤淋巴结综合征的辅助诊断价值

目的探讨冠状动脉Z值联合发热时间、白细胞介素-6(IL-6)、C反应蛋白(CRP)四联指标模型对黏膜皮肤淋巴结综合征(又称“川崎病”)的辅助诊断价值。方法选取2017年1月至2022年12月厦门大学附属中山医院儿科收治的怀疑为川崎病的患儿165例,以临床诊断标准作为金标准最终确诊的83例为病例组(包括不完全川崎病),排除川崎病诊断的82例为对照组。收集患儿的临床资料和冠脉Z值,采用多因素logistic回归分析发病的独立危险因素,构建川崎病四联指标模型。绘制受试者工作特征曲线(ROC曲线),计算曲线下面积(AUC),用约登指数确定最佳诊断阈值。用Kappa值评价四联指标模型与临床诊断标准的一致性。结果冠脉Z值、发热时间、IL-6、CRP是川崎病的独立危险因素,最佳诊断阈值分别为:冠脉Z值1.5,发热时间5.5 d,IL-631 pg/mL,CRP 42 mg/L。基于独立危险因素构建的四联指标模型AUC为0.960,Kappa值为0.867,诊断价值高于各独立危险因素,与临床诊断标准具有较好的一致性。结论冠脉Z值联合发热时间、IL-6、CRP构建的四联指标模型能有效地辅助临床诊断并减少漏诊,为提高KD诊断效率提供参考依据。

慢性乙型肝炎者外周血SAA/CRP、NLR水平与HBV-DNA载量、病情程度的相关性分析

目的探究慢性乙型肝炎(chronic hepatitis B,CHB)患者外周血淀粉样蛋白A(serum amyloid A,SAA)与C反应蛋白(C-reactive protein,CRP)比值(SAA/CRP)、中性粒细胞与淋巴细胞比值(neutrophils lymphocytes ratio,NLR)水平与乙型肝炎病毒-脱氧核糖核酸(HBV-DNA)载量及病情程度的相关性。方法选取2020年6月至2022年6月达州市中西医结合医院100例CHB患者作为研究组,根据病情程度分为轻度(单纯CHB,n=36)、中度(乙肝代偿期肝硬化,n=33)和重度(乙肝失代偿期肝硬化,n=31)。另选同期、同年龄段50例健康志愿者作为对照组,比较研究组不同病情程度、对照组一般资料、血清SAA/CRP、NLR水平,并比较研究组不同HBV-DNA载量患者血清SAA/CRP、NLR水平,分析CHB患者血清SAA/CRP、NLR水平与HBV-DNA载量、病情程度的相关性;所有患者均行抗病毒治疗,治疗24周,比较不同抗病毒疗效患者治疗前、治疗后12周、24周血清SAA/CRP、NLR水平及变化值,分析治疗前后血清SAA/CRP、NLR水平变化值预测疗效的价值。结果重度CHB患者血清SAA/CRP、NLR水平>中度CHB患者>轻度CHB患者>健康人群(P<0.05);高载量患者血清SAA/CRP、NLR水平>中载量患者>轻载量患者(P<0.05);CHB患者血清SAA/CRP、NLR水平与HBV-DNA载量(r=0.756、0.709)、病情程度(r=0.776、0.745)呈正相关(P<0.05);无应答患者治疗后12周、24周外周血SAA/CRP、NLR水平均高于应答患者,变化值均低于应答患者(P<0.05);SAA/CRP△1、NLR△1单独预测的AUC分别为0.752、0.773,联合预测△1的AUC为0.861;SAA/CRP△2、NLR△2单独预测的AUC分别为0.796、0.819,联合预测△2的AUC为0.967,大于联合预测△1的AUC(P<0.05)。结论CHB患者的SAA/CRP、NLR与CHB HBV-DNA载量及病情程度具有相关性,临床可通过其水平变化评估病情及预测预后。

Sweet综合征口腔黏膜表现1例报道及文献回顾

目的探讨Sweet综合征的口腔黏膜病损表现,为临床早发现并正确诊断该病提供参考。方法报道1例60岁女性Sweet综合征患者的口腔黏膜病损表现,并结合相关文献对Sweet综合征进行分析。结果患者双下肢皮肤红斑伴口腔黏膜破溃疼痛3 d,患者皮损症状较轻,但口腔黏膜多发性大面积糜烂,疼痛明显,故首诊于口腔科。患者发病过程中伴有发烧,体温38.5℃;实验室检查示C反应蛋白升高(35.2 mg/L),血沉加快(77.00 mm/h);患者两侧膝盖及下肢可见散在分布红色斑块,轻度压痛,皮损组织病理学检查示:真皮全层见散在不成熟中性粒细胞聚集灶浸润。根据患者临床体征和实验室检查,皮损组织病理结果的镜下符合Sweet综合征的表现,诊断为Sweet综合征。给予患者1 mL复方倍他米松注射液肌肉注射仅1次;患者对糖皮质激素治疗效果反应良好;口腔采用复方氯己定溶液含漱,病损黏膜处重组牛碱性成纤维细胞生长因子溶液外用,3次/d,疗程为1周;用药4 d后复诊,体温恢复正常,口腔病损明显减轻;2周后复诊,小腿及膝盖处红斑几乎全部消退,口腔黏膜病损基本消失;半年后随访,结果显示皮损未复发;2年后随访,病情稳定,病损未见复发。回顾相关文献表明,Sweet综合征是一种少见的病因不明的炎性反应性皮病,临床上可分为3种类型:特发型、肿瘤相关型以及药物诱导型,男女患病比为1∶4,典型临床表现为急性出现的疼痛性红色斑块或结节,病损多位于四肢,常伴发热,外周血中性粒细胞数目增多,血沉加快,C反应蛋白阳性。系统应用糖皮质激素是本病最重要的治疗方法,大多数患者可在短期内改善皮损,但可能会存在潜在感染或停药后复发的情况。部分Sweet综合征患者可伴有口腔病损,但目前有关Sweet综合征在口腔黏膜表现的病例报道却很少,使得临床容易误诊。结论口腔黏膜病损可能为Sweet综合征的皮肤外表现,应综合考虑患者的全身情况,尽快完善皮肤活检以明确诊断,以免延误病情。

Associations of plasma homocysteine and high-sensitivity C-reactive protein levels with arterial stiffness in Chinese population： a community-based study

Background Arterial stiffness increases with age and is also associated with traditional cardiovascular risk factors. Little is known about the relations of homocysteine and high-sensitivity C-reactive protein （hs-CRP） to arterial stiffness in the Chinese community. The aim of the present study was to investigate the association of plasma homocysteine and hs-CRP levels with arterial stiffness in a community-based cohort. Methods We related levels of homocysteine and hs-CRP to four measures of arterial stiffness （carotid-femoral pulse wave velocity （PWV）, carotid-radial PWV, carotid-ankle PWV and heart rate corrected augmentation index） in 1680 participants from two communities of Beijing, China. Arterial stiffness was measured within two days of the time of biomarker measurement. Results In univariate analysis, homocysteine was positively associated with the carotid-femoral PWV （r=0.211, P 〈0.0001）, carotid-radial PWV （r=0.120, P 〈0.0001） and carotid-ankle PWV （r=0.148, P 〈0.0001）, whereas it was inversely related to the augmentation index （r= -0.052, P=0.016）. Hs-CRP was positively associated with the carotid-femoral PWV （r=0.074, P=0.001） and carotid-ankle PWV （r=0.050, P=0.02）. In multiple-adjusted models （R2=0.57）, homocysteine levels remained a significant determinant of the carotid-femoral PWV （standardized 13=0.065, P=0.007）, whereas the association of hs-CRP with measurements of arterial stiffness was not present. Conclusions In the Chinese population, plasma homocysteine levels are associated with alterations of aortic stiffness, whereas plasma levels of hs-CRP are not independently related to artery stiffening.

CT动脉增强分数联合血清NLR、CRP对失代偿期肝硬化患者预后的评估价值

目的:分析研究CT动脉增强分数联合血清NLR、CRP对失代偿期肝硬化患者预后的评估价值。方法:选取2019年4月至2022年4月汕头市潮阳区大峰医院收治的120例失代偿期肝硬化患者作为研究对象,对患者进行1年随访,以死亡为终点事件,将患者分为生存组(n=84)与死亡组(n=36)。以多因素Logistic回归分析CT动脉增强分数及血清NLR、CRP与失代偿期肝硬化患者预后的关系,并绘制ROC曲线分析CT动脉增强分数联合血清NLR、CRP对失代偿期肝硬化患者预后的预测价值。结果:多因素Logistic回归分析显示,HAEF升高(OR=1.941)、H/S升高(OR=1.815)、PTA降低(OR=2.100)、ALB降低(OR=2.008)、NLR升高(OR=2.079)及CRP水平升高(OR=2.134)均是失代偿期肝硬化患者预后的独立危险因素(P<0.05);ROC曲线分析结果显示HAEF、H/S、NLR、CRP水平及联合检测的曲线下面积(AUC)分别为0.862、0.808、0.831、0.933、0.989,联合检测优于单一检测(P<0.05)。结论:CT动脉增强分数联合血清NLR、CRP对失代偿期肝硬化患者预后具有较好的评估价值。

N乙酰半胱氨酸联合噻托溴铵对慢性阻塞性肺疾病急性加重期患者血清超敏C反应蛋白人中性粒细胞肽五聚素3及肺功能的影响

目的探讨N乙酰半胱氨酸联合噻托溴铵对慢性阻塞性肺疾病急性加重期(AECOPD)患者血清超敏C反应蛋白(hsCRP)、人中性粒细胞肽13(HNP13)、五聚素3(PTX3)及肺功能的影响。方法本研究为前瞻性研究,102例患者均来源于济源市中医院,选取时间为2019年8月至2022年8月,按随机数字表法分为对照组(51例,噻托溴铵吸入治疗)和研究组(51例,在噻托溴铵吸入治疗的基础上加用N乙酰半胱氨酸治疗)。2组患者均进行为期14 d的治疗。将2组患者治疗效果,治疗前后肺功能指标的变化、血清hsCRP、HNP13、PTX3及氧化应激指标水平进行对比。结果研究组与对照组患者的临床总有效率分别为88.2%(45/51)、72.6%(37/51),研究组比对照组高;治疗后2组患者肺功能指标、超氧化物歧化酶(SOD)均较治疗前上升,且研究组患者上述指标比对照组高,而治疗后2组患者血清hsCRP、HNP13、PTX3及丙二醛(MDA)、一氧化氮(NO)指标水平均较治疗前下降,且研究组患者均低于对照组(P<0.05)。结论N乙酰半胱氨酸联合噻托溴铵治疗急性加重期COPD患者,可提升肺功能指标水平,对氧化应激反应予以调节,减轻炎症反应,临床疗效确切。

高密度脂蛋白胆固醇、C反应蛋白水平与冠心病合并心衰患者心功能及易损斑块的关系

目的探讨冠心病(CHD)合并心衰(HF)患者血清高密度脂蛋白胆固醇(HDL-C)、C反应蛋白(CRP)水平变化与临床心功能分级及易损斑块的关系。方法选取本院2021年1月~2023年6月收治的103例CHD合并HF患者,采用直接测定法及免疫比浊法检测患者入院时血清HDL-C、CRP水平。根据美国心脏病协会(NYHA)心功能分级标准将患者心功能分为Ⅰ~Ⅱ级、Ⅲ级、Ⅳ级;所有患者进行光学相干断层成像(OCT)检查,根据检查结果的斑块性质将患者分为易损组和稳定组,比较不同心功能分级及不同斑块性质患者的血清HDL-C、CRP水平变化情况;采用Spearman相关性分析法分析血清HDL-C、CRP水平与CHD合并HF患者心功能分级及冠状动脉易损斑块的相关性。结果不同心功能分级患者血清HDL-C、CRP水平比较差异有统计学意义(P<0.05),其中HDL-C比较:Ⅰ~Ⅱ级>Ⅲ级>Ⅳ级(P<0.05),CRP比较:Ⅰ~Ⅱ级<Ⅲ级<Ⅳ级(P<0.05)。易损组血清HDL-C水平较稳定斑块组低(P<0.05),CRP水平较稳定组高(P<0.05)。Spearman相关性分析显示,血清HDL-C水平与心功能分级、易损斑块呈负相关(r=-0.758、-0.788,P<0.05),血清CRP水平与心功能分级、易损斑块呈正相关(r=0.883、0.862,P<0.05)。结论CHD合并HF患者血清HDL-C、CRP水平与其心功能分级及易损斑块的发生紧密相关,血清HDL-C水平越低、CRP水平越高,心功能受损程度及斑块易损风险越高。

降钙素原与白介素-6的相关性优于传统的炎症指标

目的 :确定全身性感染患者的传统炎症指标〔体温、白细胞计数、中性粒细胞比例、中性粒细胞计数、C反应蛋白 (CRP)〕及降钙素原 (PCT)与白介素 6 (IL 6 )水平间的相关关系。方法 :共有 5 1例患者入选。临床发生全身性感染或全身性炎症反应综合征 (SIRS)后 2 4小时内测定血清 PCT、IL 6和 CRP,同时记录白细胞计数、中性粒细胞比例、中性粒细胞计数和最高体温。结果 :PCT与血清 IL 6水平密切相关。比较受试者工作特征曲线下面积 (AU C) ,PCT对 IL 6水平 (以 5 0 0 ng/ L 和 10 0 0 ng/ L 作为临界值 )的预测能力最强 (分别为 0 .6 85和 0 .85 8) ,体温 (分别为 0 .6 6 2和 0 .792 )和 CRP(分别为 0 .6 2 5和 0 .72 7)的预测能力中等 ,而白细胞计数、中性粒细胞比例和中性粒细胞计数的预测能力最差。 PCT的敏感性、特异性、阳性预期值和阴性预期值也最高。结论 :与传统的炎症指标相比 。

血清PCT与CRP检测在肝硬化并肺部感染患者诊治中的临床价值

目的探讨血清降钙素原(PCT)与C反应蛋白(CRP)联合检测在肝硬化合并肺部感染患者诊治中的临床价值。方法选择2014年1月至2015年9月在该院感染科住院的肝硬化合并肺部感染确诊患者40例纳入观察组,另选择同期住院的肝硬化无肺部及其他部位感染患者40例纳入对照组,检测两组患者的血清PCT及CRP,观察患者的呼吸道症状及体征变化,并进行统计学分析。结果观察组患者的PCT(11.6±3.2)ng/mL和CRP(56.3±8.7)mg/L水平均明显高于对照组,差异有统计学意义(P<0.01);观察组患者的PCT和CRP阳性率分别为82.5%和95.0%,均高于对照组,差异有统计学意义(P<0.01);血清PCT与CRP联合检测的特异度和灵敏度分别为94.6%和96.0%,明显高于二者单独检测时;血清PCT水平与肝硬化并肺部细菌感染患者的呼吸道症状及体征改善时间存正相关关系(P<0.05)。结论肝硬化合并肺部细菌感染患者应用PCT和CRP联合检测对判断其病情严重程度、预后及抗感染治疗疗程等具有重要临床参考价值。

脊柱结核手术时机选择的初步研究

目的:观察脊柱结核患者手术前后红细胞沉降率(erythrocyte sedimentation rate,ESR),C-反应蛋白(Creactive protein,CRP)及神经功能的变化,探讨手术介入时机,评价其对手术安全性的影响。方法:对2012年3月至2017年3月行手术治疗的387例脊柱结核患者进行回顾性分析,男278例,女109例;年龄12~86(49.9±19.1)岁;颈椎结核64例,胸椎结核86例,胸腰段结核76例,腰椎结核161例;单节段受累297例,多节段受累90例。其中62例出现神经系统损害,术前脊髓神经功能ASIA残损分级:A级5例,B级8例,C级39例,D级10例。根据术前抗结核治疗时间长短分为A组(术前接受2~4周的常规四联抗结核治疗)256例和B组(术前接受>4周的常规四联抗结核治疗)131例。比较两组在性别、年龄、病变部位及范围、手术入路、术前耐药等一般临床特征上的均衡性。动态观察两组患者ESR、CRP,疼痛视觉模拟评分(visual analogue scale,VAS),Oswestry功能障碍指数(Oswestry Disability Index,ODI),Frankel分级和术后并发症等情况。结果:387例患者均获得随访,时间12~36(18.3±4.5)个月。两组性别、年龄、病变部位及范围、手术入路、术前耐药等特征方面差异均无统计学意义。两组患者共有32例术后未愈,发生率为8.27%。两组患者手术治疗后VAS评分及ODI均明显改善(P<0.05),但两组间同一时间点差异无统计学意义(P>0.05)。术后1~14 d,神经功能开始逐渐恢复,神经功能分级提升1~3级;术后3个月至末次随访,完全恢复52例,部分恢复8例,无改善2例。两组间患者在入院前、术后1个月、末次随访的ESR、CRP差异无统计学意义(P>0.05)。结论:脊柱结核患者术前经过2~4周的抗结核治疗,ESR、CRP处于下降期或稳定期即可进行手术。对于脊柱结核伴截瘫患者,原则上应在术前积极处理合并症后尽早手术治疗,无须急诊手术。

胸椎旁神经阻滞术联合臭氧治疗带状疱疹后遗神经痛临床观察

目的评价胸椎旁神经阻滞术联合臭氧治疗带状疱疹后遗神经痛临床疗效。方法共85例带状疱疹后遗神经痛患者随机接受基础口服药物+维生素B12肌内注射+皮损区局部阻滞(A组),或基础口服药物+复方三维B肌内注射+皮损区局部神经阻滞(B组),或基础口服药物+复方三维B肌内注射+胸椎旁神经阻滞+皮损区局部神经阻滞(C组),或基础口服药物+复方三维B肌内注射+胸椎旁神经阻滞及臭氧注射+皮损区局部神经阻滞(D组)。分别于治疗前和治疗4周后进行视觉模拟评分(VAS)、睡眠质量评分(QS)、抑郁自评量表(SDS)评分和血清C.反应蛋白(CRP)检测,综合评价治疗效果。结果经治疗后,不同处理组患者VAS、QS和SDS评分均低于治疗前(P<0.05);A、B和C组患者治疗前后血清C.反应蛋白水平无明显变化(均P>0.05);D组患者治疗后血清C.反应蛋白水平低于治疗前(P<0.05)。结论胸椎旁神经阻滞术联合臭氧是治疗带状疱疹后遗神经痛快捷而有效的方法。

C-反应蛋白对儿科细菌感染性疾病的临床诊断价值

目的探讨血清C-反应蛋白(CRP)检测在儿童细菌性感染疾病的诊断价值。方法(1)用HITA-CHI日立7600全自动生化分析仪检测82例细菌感染患儿(观察组)及30例健康儿(对照组)的血清CRP含量。(2)用血细胞计数仪ABX-PENTRA60对以上82例细菌感染患儿(观察组)及30例健康儿(对照组)进行白细胞计数。(3)将以上两种方法做统计学比较。结果观察组各种疾病的CRP检测值均显著高于对照组(P<0.001),82例患儿中,CRP阳性78例,阳性率95.1%;白细胞水平升高64例,阳性率78.0%,两种检测阳性率差异有统计学意义(P<0.01)。结论CRP检测对儿科细菌性感染疾病的诊断和治疗有一定的临床应用价值,可以作为诊断小儿细菌性感染和观察治疗效果的敏感指标。

急性冠状动脉综合征患者血浆C-反应蛋白变化与脂质相关性的研究

目的 研究急性冠状动脉综合征 (ACS)患者急性期反应以及血浆C -反应蛋白 (CRP)水平与血浆低密度脂蛋白 (LDL)、一氧化氮 (NO)、总胆固醇 (TC)、甘油三酯 (TG)的关系。方法 符合ACS诊断的 4 5例患者于入院后第 2天凌晨空腹抽取肘静脉血 5mL ,应用速率散射免疫比浊法测定CRP并测定LDL、NO、TC、TG ,并设健康对照组。结果 ACS患者CRP水平显著升高 ,与对照组比较有显著差异 (P <0 .0 1) ;ACS患者CRP水平和LDL、NO、TC、TG有显著相关性 (P <0 .0 1)。结论 调节LDL、NO、TC、TG的水平 ,达到降低CRP水平的目的是防治ACS发生、发展的有效措施。