Changes of serum high sensitive C-reactive protein in patients with acute cerebral infarction

BACKGROUND： Serum high sensitive C-reactive protein （hs-CRP）, which regards as a high sensitive mark of systemic inflammatory response syndrome, can provide a lot of valuable information for the treatment and prognosis of cerebrovascular disease. OBJECTIVE： To observe the differences of blood glucose, lipid, homocysteine and previous disease history among patients with acute cerebral infarction at various levels of hs-CRP and compare changes of hs-CRP of patients with various degrees of neurologic impairment. DESIGN： Contrast observation. SETTING： Department of Neurology, Shenzhou Hospital, Shenyang Medical College. PARTICIPANTS： A total of 102 patients with acute cerebral infarction were selected from Department of Neurology, Shenzhou Hospital of Shenyang Medical College from February 2005 to September 2006, including 55 males and 47 females aged from 55 to 86 years. All accepted patients met the diagnostic criteria of cerebral infarction established by the Fourth National Cerebrovascular Disease Academic Meeting and were diagnosed with CT or MRI examination. All patients provided the confirmed consent. Based on clinical criteria of neurologic impairment established by the Fourth National Cerebrovascular Disease Academic Meeting, patients were randomly divided into mild group （0 - 15 points, n =46）, moderate group （16 - 30 points, n =38） and severe group （31 - 45 points, n =18）. In addition, based on hs-CRP level within 72 hours, patients were divided into normal group （hs-CRP ≤3 mg/L, n =53） and increasing group （hs-CRP 〉 3 mg/L, n =-49）. METHODS： ① 2 mL venous blood was selected from hospitalized patients in the next morning to separate serum. Quantitative measurement of hs-CRP was dealt with Latex Enhnced Turbidimetric Immunoassay （LETIA）. ②Fasting venous blood was colleted from hospitalized patients in the next morning to measure numeration of white blood cells, fibrinogen, blood glucose, total cholesterol （TC）, triacylglycerol （TG）, high density lipoprotein cholesterol （HDL-C）, low density lipoprotein cholesterol （LDL-C） and homocysteine. ③Measurement data were compared with t test or analysis of variance. MAIN OUTCOME MEASURES： ①Comparisons of serum biochemical indexes among patients with various levels of hs-CRP; ②comparisons of risk factors among patients with various levels of hs-CRP; ③comparisons of levels of hs-CRP among patients with various degrees of clinical neurologic impairment. RESULTS： A total of 102 patients were involved in the final analysis. ①Plasma fibrinogen and numeration of leucocytes were more in the increasing group than those in the normal group （t =4.39, 3.54, P 〈 0.01）; while, there were no significant differences of blood glucose, TC, TG, HDL-C, LDL-C and homocysteine between the two groups （P 〉 0.05）. ② Percentage of patients with hypertension and diabetes mellitus （DM） was higher in the increasing group than the normal group （ Х^2=3.98, 4.23, P 〈 0.05）; while, percentage of patients with smoking in the increasing group was not significantly different from that of patients in the normal group （P 〉 0.05）. ③Level of hs-CRP of patients with severe neurologic impairment was higher than that of patients with moderate neurologic impairment （t =2.273, P 〈 0.05）; that of patients with moderate neurologic impairment was higher than that of patients with mild neurologic impairment （t =2.586, P 〈 0.05）; that of patients with severe neurologic impairment was obviously higher than that of patients with mild neurologic impairment （t = 4.913, P 〈 0.01）. CONCLUSION： ① With the increase of hs-CRP, plasma fibrinogen and numeration of leucocytes of patients with acute cerebral infarction is increased, especially, they are increased remarkably among patients who have history of diabetes mellitus and hypertension. ②Increase of level of hs-CRP can be regarded as one of marks to evaluate severity of acute stroke.

Correlation between serum C1q tumor necrosis factor-related protein 4 and high-sensitivity C-reactive protein levels and coronary heart disease

Objective:To investigate the relationship between serum levels of C1q tumor necrosis factorrelated protein 4(CTRP4)and hypersensitive C reactive protein(hs-CRP)and coronary heart disease(CHD)and its clinical value.Methods:128 patients underwent coronary angiography in our hospital,63 males,65 women,Based on blood sugar levels and coronary angiography,Divided into pure coronary heart disease(CHD)group 62 cases,Coronary heart disease with diabetes(DM+CHD)group 66 cases,A total of 126 patients were selected as control group,65 men,61 women,CTRP4 and hs-CRP levels in serum,Using Pearson correlation analysis to assess the correlation between Gennisi score and CTRP4、hs-CRP,Analysis of three groups of biochemical indicators,CTRP4、hs-CRP level changes and clinical significance.Results:The CTRP4、hs-CRP level of DM+CHD group was significantly higher than that of control group and CHD group(P DM+CHD 0.05).The CTRP4、hs-CRP level of the three-vessel coronary artery lesion group in the experimental group was higher than that in the two-vessel lesion group(P﹤0.05),Double branch lesion group was higher than single branch lesion group(P﹤0.05);Correlation analysis shows,There was a significant positive correlation between the CTRP4、hs-CRP level of CHD group and DM+CHD group and the Gennisi score(P DM+CHD 0.05).ROC curves show,CTRP4 and hs-CRP levels had predictive value(CHD group,AUC=0.940,0.934,DM+CHD group,AUC=0.980,0.964),Two associations(CHD:AUC=0.961,P﹤0.001,DM+CHD group:AUCDM+CHD 0.982,P﹤0.001)the predictive value is high.Conclusion:Serum CTRP4 and hs-CRP are positively related to the severity of coronary heart disease,and the sensitivity and specificity of predicting coronary heart disease are high,which is helpful for the identification and early prevention of coronary heart disease,and has certain clinical reference value.

冠心病经皮冠状动脉介入术治疗前后患者血清肺炎衣原体抗体IgA、超敏C-反应蛋白、血管生成素-2变化及预后预测价值研究

目的:探讨冠心病(CHD)经皮冠状动脉介入术治疗前后患者血清肺炎衣原体抗体IgA(CP-IgA)、超敏C-反应蛋白(hs-CRP)及血管生成素-2(Ang-2)变化及预后预测价值。方法:选取CHD患者135例为观察组,根据患者预后情况分为预后良好组(119例)及预后不良组(16例)。另选取同期体检健康者135例为对照组。比较观察组和对照组、观察组PCI前后以及两个亚组血清CP-IgA、hs-CRP及Ang-2水平。分析血清CP-IgA、hs-CRP及Ang-2与PCI术后CHD患者预后的相关性。分析血清CP-IgA、 hs-CRP及Ang-2对PCI术后CHD患者预后的预测价值。结果:观察组血清CP-IgA、hs-CRP及Ang-2水平高于对照组(均P<0.05)。观察组患者PCI术后血清CP-IgA及Ang-2水平较PCI术前降低,血清hs-CRP水平较PCI术前升高(均P<0.05)。预后良好组患者血清CP-IgA、hs-CRP及Ang-2水平低于预后不良组(均P<0.05)。血清CP-IgA、hs-CRP及Ang-2与PCI术后CHD患者预后呈正相关(均P<0.05)。血清CP-IgA、hs-CRP及Ang-2单独预测PCI术后CHD患者预后的曲线下面积(AUC)小于三项联合(均P<0.05)。结论:CHD患者血清CP-IgA、hs-CRP及Ang-2水平升高,PCI术后血清CP-IgA和Ang-2水平降低,hs-CRP水平升高。预后不良患者血清CP-IgA、hs-CRP及Ang-2水平升高,且三者联合对PCI术后CHD患者预后的预测价值较高。

Downstream signaling of reactive oxygen species,protein kinase C epsilon translocation and delayed neuroprotection in sevoflurane preconditioned rats following cerebral ischemia/reperfusion

BACKGROUND： Brief exposure to the anesthetic sevoflurane results in delayed neuroprotection, However, few studies have addressed delayed neuroprotection after preconditioning with a single administration of sevoflurane. OBJECTIVE： To explore the relationship between a single preconditioning administration of sevoflurane and reactive oxygen species production and protein kinase C-epsilon （PKC-ε ） translocation. DESIGN, TIME, AND SETTING： The randomized, controlled, animal experiment was conducted at the Central Laboratory, Xiangya Hospital, Central South University, China from November 2007 to April 2008. MATERIALS： A total of 120 healthy, male, Sprague Dawley rats were equally and randomly assigned into five groups： sham operation, ischemia/reperfusion, sevoflurane, 2-mercaptopropionylglycine （2-MPG, a selective reactive oxygen species scavenger） ＋ sevoflurane （MPG ＋ sevoflurane）, and MPG. Sevoflurane （Baxter, USA） and MPG （Sigma, USA） were used in this study. METHODS： Intervention consisted of three procedures. （1） MPG injection： a selective reactive oxygen species scavenger, MPG （20 mg/kg）, was infused into the rat caudal vein in the MPG and MPG ＋ sevoflurane groups. （2） Sevoflurane preconditioning： 30 minutes following MPG injection, rats in the sevoflurane and MPG ＋ sevoflurane groups breathed a mixed gas of 2.4% sevoflurane and 97.6% oxygen for 60 minutes. Rats in the sham operation, ischemia/reperfusion, and MPG groups breathed 100% pure oxygen for 60 minutes. （3） IschemiaJreperfusion： 24 hours after sevoflurane or pure oxygen preconditioning, middle cerebral artery occlusion models were established in the ischemia/reperfusion, sevoflurane, MPG ＋ sevoflurane, and MPG groups. Following 2 hours ischemia/6 hours and 24 hours reperfusion, the carotid artery was separated, but the middle cerebral artery was not occluded, in the sham operation group. MAIN OUTCOME MEASURES： In the ischemic hemisphere, PKC-ε translocation in the rat parietal cortex was measured by Western blot analysis. Infarct volume was calculated using the TTC assay. Neurological deficits were evaluated in rats using a scoring system of 8 points. RESULTS： After 6 hours reperfusion, the ratio of PKC-ε in membrane/（cytosol ＋ membrane） was significantly less in the sham operation group than in the ischemia/reperfusion, sevoflurane, MPG ＋ sevoflurane）, and MPG groups （P 〈 0.05）. The ratio of PKC-ε in membrane/（cytosol ＋ membrane） was significantly greater in the sevoflurane group than in the sham operation, ischemia/reperfusion, MPG ＋ sevoflurane, and MPG groups （P 〈 0.05）. No significant differences were observed in the ischemiaJreperfusJon, M PG ＋ sevoflurane, and MPG groups （P 〉 0.05）. Following 24 hours reperfusion, the ratio of PKC-ε in membrane/（cytosol ＋ membrane） was significantly less in the sham operation group than in the ischemia/reperfusion, sevoflurane, MPG ＋ sevoflurane, and MPG groups （P 〈 0.05）. No significant differences were detected in the ischemia/reperfusion, sevoflurane, MPG ＋ sevoflurane, and MPG groups （P 〉 0.05）. Compared with the ischemia/reperfusion, MPG ＋ sevoflurane, and MPG groups, infarct volume was significantly smaller, and neurological deficits were significantly improved, in the sevoflurane group （P 〈 0.05）. No significant differences in infarct volume and neurological deficits were observed among the ischemia/reperfusion, MPG ＋ sevoflurane, and MPG groups （P 〉 0.05）. Infarcts or neurological deficits were not detected in the sham operation group. CONCLUSION： A single preconditioning administration of sevoflurane reduced infarct volumes and improved neurological deficits in ischemic rats. Delayed neuroprotection may be mediated by reactive oxygen species and correlated to PKC- ε activation.

超敏C-反应蛋白(hs-CRP)与血脂检验在糖尿病新发患者中的应用价值研究

目的 分析超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)与血脂检验在糖尿病新发患者中的应用价值。方法 选取2020年1月—2022年12月武警贵州总队医院内一科收治的糖尿病患者50例为观察组,另将同一时期收治的健康志愿者共50例作为对照组,比较两组血糖水平、hs-CRP与血脂高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、三酰甘油(triacylglycerol,TG)以及血清总胆固醇(serum total cholesterol,TC),同时分析血糖与hs-CRP、血脂(HDL-C、LDL-C、TG、TC)相关性。结果 观察组血糖、hs-CRP与血脂水平优于对照组,差异有统计学意义(P<0.05);不同空腹血糖患者的hs-CRP与血脂水平比较,差异有统计学意义(P<0.05);患者血糖水平与血脂水平、hs-CRP均为正相关关联。结论 在糖尿病新发患者的临床检验中不仅可通过血糖观察疾病严重程度,同时还可利用hs-CRP与血脂评估患者的病情状态与疾病治疗效果,对临床诊断与治疗有重要意义。

Relationship among soluble CD105, hypersensitive C-reactive protein and coronary plaque morphology： an intravascular ultrasound study

Background Rupture of unstable plaque with subsequent thrombus formation is the common pathophysiological substrate of acute coronary syndrome （ACS）. It is of potential significance to explore the blood indexes predicting plaque characteristics. We investigated the relationship among soluble CD105, hypersensitive C-reactive protein （hs-CRP）, and coronary plaque morphology.Methods A clinical study from April 2004 to December 2006 was conducted in 130 patients who were divided into 3 groups： 56 patients （43.1%） in stable angina （SA） group, 52 patients （40.0%） in unstable angina （UA） group and 22 patients （16.9%） in acute myocardial infarction group. The concentrations of soluble CD105 and hs-CRP were measured in all of the patients by cardioangiography （CAG）. Plasma samples of arterial blood were collected prior to the procedure. The levels of soluble CD105 and hs-CRP were measured by enzyme-linked immunosorbent assay （ELISA）.Results Unstable and ruptured plaque was found more frequently in patients with acute myocardial infarction and UA. External elastic membrane cross-sectional area （EEM CSA）, plaque area, lipid pool area and plaque burden were significantly larger in the ruptured and unstable plaque group. Positive remodeling, thinner fabric-cap, smaller minimal lumen cross-sectional area （MLA）, dissection and thrombus were significantly more frequent in the ruptured and unstable plaque group. Remodeling index （RI） was positively correlated with the levels of soluble CD105 in the UA group （r=0.628, P〈0.01） and the acute myocardial infarction group （r=0.639, P〈0.01）. The levels of soluble CD105 and hs-CRP were higher in the ruptured plaque group. Soluble CD105 〉4.3 ng/ml was used to predict ruptured plaque with a receiver operating characteristic （ROC） curve area of 0.77 （95% confidence interval （CI）, 66.8%-87.2%）, a sensitivity of 72.8%, a specificity of 78.0% and an accuracy of 70.2% （P〈0.01）, similarly for hs-CRP 〉 5.0 mg/ml with a ROC curve area of 0.70 （95% CI, 59.2%-80.2%）, a sensitivity of 70.2%, a specificity of 76.2% and an accuracy of 67.2% （P〈0.01）.Conclusions The plaque characteristics correlate with the clinical presentation. The elevation of soluble CD105 and hs-CRP is related to the plaque instability and rupture.

研究超敏C-反应蛋白联合血常规对小儿支气管炎的诊断效果

目的 探讨小儿支气管炎采用超敏C-反应蛋白(high-sensitivity C-reactive protein, hs-CRP)联合血常规诊断的效果。方法 选取2022年1—12月菏泽市妇幼保健院收治的68例支气管炎患儿作为观察组,另选取同期40例健康体检儿童作为对照组,均接受hs-CRP、血常规检验,统计两组hs-CRP、白细胞计数(white blood cell, WBC)水平,比较单一检测与联合检测的阳性检出率及诊断效能。结果 观察组hs-CRP(14.93±2.67)mg/L、WBC(13.72±3.19)×10^(9)/L水平较对照组[(7.29±1.14)mg/L、(6.07±1.38)×10^(9)/L]更高,差异有统计学意义(P<0.05);hs-CRP检测诊断灵敏度为70.59%,特异度为75.00%,阳性预测值为82.76%,阴性预测值为60.00%,准确性为72.22%,血常规检测分别为63.24%、67.50%、76.79%、51.92%、64.81%,联合检测分别为91.18%、97.50%、98.41%、86.67%、93.52%,联合检测诊断效能(灵敏度、特异度、阳性预测值、阴性预测值、准确性)高于单一检测,差异有统计学意义(P<0.05)。结论 hs-CRP联合血常规应用于小儿支气管炎诊断中,能够提高阳性检出率,提升诊断效能,应用价值较高。

多重微球流式免疫荧光技术对肺癌患者外周血IL-1β、IL-6、IFN-γ水平测定及与hs-CRP的相关性分析

目的探讨多重微球流式免疫荧光技术在肺癌患者外周血白细胞介素(IL)-1β、IL-6和干扰素γ(IFN-γ)细胞因子的表达情况及与超敏C反应蛋白(hs-CRP)相关性分析。方法采用回顾性研究的方法,选择张家港市中医医院(下称该院)肿瘤科和肺病科收治的30例肺癌患者作为肺癌组,另选择同期该院收治的30例肺炎患者作为肺炎组,同时选取同期该院体检健康者30例作为对照组,通过多重微球流式免疫荧光技术检测血清中IL-1β、IL-6和IFN-γ水平,同时利用乳胶增强免疫散射比浊法测定外周血全血中hs-CRP水平。结果肺癌组与对照组比较,IL-1β、IL-6和hs-CRP水平显著升高,差异有统计学意义(P<0.001),而IFN-γ水平差异无统计学意义(P>0.05);肺炎组与对照组比较,IL-1β、IL-6、IFN-γ、hs-CRP水平均显著升高,差异有统计学意义(P<0.001);肺癌组与肺炎组比较,IL-6、IFN-γ、hs-CRP水平明显降低且IL-1β水平升高,差异均有统计学意义(P<0.05);肺癌组、肺炎组IL-6和hs-CRP水平分别进行Pearson相关性分析,均无明显的相关性。结论IL-1β、IL-6、IFN-γ可以作为有效评估肺癌患者免疫功能的辅助指标,多重微球流式免疫荧光技术的应用对于肺癌的诊断及监测具有潜在的临床应用价值。

右美托咪定对孕产妇椎管内麻醉期间寒战及血流动力学的影响

目的 探讨右美托咪定对孕产妇行椎管内麻醉期间寒战及血流动力学的影响。方法 纳入384例术中发生寒战的剖宫产产妇并随机分为观察组和对照组,各192例。对照组采用哌替啶对寒战进行治疗,观察组采用右美托咪定。比较2组麻醉效果、寒战治疗的疗效、血流动力学指标及血清中超敏C反应蛋白(hs-CRP)、前列腺素E2(PGE2)、皮质醇(Cor)水平。结果 相较于对照组,观察组的寒战停止时间较短,寒战控制情况较好(P<0.05);2组舒张压、收缩压、心率、血氧饱和度均发生改变,但观察组波动幅度显著小于对照组(P<0.05);2组应激指标均升高,但观察组hs-CRP、PGE2、Cor水平较对照组升高幅度小(P<0.05);观察组不良反应总发生率低于对照组(P<0.05)。结论 临床应用右美托咪定对剖宫产产妇进行椎管内麻醉治疗寒战的效果较好,可稳定机体血流动力学水平,临床应用价值较高。

脂必泰联合阿托伐他汀钙对脑梗死患者颈动脉粥样硬化斑块临床研究

目的 探讨脂必泰胶囊对脑梗死急性期患者颈动脉粥样硬化斑块的影响。方法 选取90例脑梗死急性期患者,采用随机数字表法将患者分为治疗组和对照组各45例。对照组给予西医常规治疗(阿托伐他汀钙片),治疗组联合脂必泰胶囊强化降脂治疗,疗程3个月。比较两组患者治疗前后血清超敏C反应蛋白(hypersensitive C-reactive protein, hs-CRP)、血脂水平、颈动脉斑块积分、斑块面积及中医证候评分。结果 治疗后,两组患者血清hs-CRP、总胆固醇(total cholesterol, TC)、甘油三酯(triglyceride, TG)、低密度脂蛋白水平(low densith lipoprotein, LDL-C)、颈动脉硬化斑块积分、斑块面积、中医证候评分均明显低于治疗前(P<0.05);且治疗组明显低于对照组,差异有统计学意义(P<0.05)。结论 脂必泰胶囊联合阿托伐他汀钙能够明显降低脑梗死急性期患者血脂和hs-CRP水平,减轻颈动脉粥样斑块,改善中医临床证候。

炎症因子在糖尿病溃疡中的作用及中医药治疗前景

背景:糖尿病溃疡是糖尿病常见并发症,表现为足部溃疡合并感染,治疗周期长,致残率和病死率较高,给患者和社会医疗带来了沉重的负担。目的:综述中医药治疗糖尿病溃疡创面的作用机制和最新治疗进展,为其进一步理论研究和临床合理应用提供依据。方法:检索中国知网、万方和PubMed数据库收录的相关文献。中文检索词为“糖尿病溃疡,中药,炎症,白细胞介素1β,白细胞介素6,肿瘤坏死因子,超敏C反应蛋白,干扰素γ,白细胞介素4,白细胞介素10”。英文检索词为“Diabetes Ulcer,Medicinal herb,Inflammation,interleukin-1β,interleukin-6,tumor necrosis factor,hypersensitive C-reactiveprotein,γ-interferon,Interleukin-4,interleukin-10”,最终纳入75篇文献进行归纳总结。结果与结论:(1)机体的高糖环境会提高促炎细胞因子水平,使糖尿病溃疡创面长期处于慢性炎症反应状态,难以愈合甚至不愈合。(2)中医在与糖尿病溃疡的长期斗争中总结出许多经验,目前不仅将糖尿病溃疡分湿热毒盛证、血脉瘀阻证、热毒伤阴证和气血两虚证4个证型以及治疗的代表方剂,还根据糖尿病溃疡的临床特点将糖尿病溃疡分为初、中、后3期并提出“清法”“温清并用”和“养法”三期不同治法。在中医辨证分型和分期的指导下,中药单体、提取物及中药复方通过下调促炎因子的表达和(或)上调抗炎因子的表达抑制炎症反应,促进糖尿病溃疡的愈合。与现代医学相比,中药物优价廉、疗效好、不良反应小,在治疗糖尿病溃疡方面有着显著的优势。(3)治疗糖尿病溃疡的中药单体、提取物及中药复方众多,如白芷、姜黄素、改良冲和膏、三黄血竭方和疮疡Ⅰ号方等,归纳后发现治疗糖尿病溃疡的中药以清热解毒、活血化瘀和敛疮生肌药为主,且中药复方的使用频率、治疗范围和治疗效果明显优于中药单体和提取物,其中最常用的是治疗湿热毒盛证的三黄血竭方和疮疡Ⅰ号方以及治疗非缺血型糖尿病溃疡的紫朱软膏。(4)然而中医药治疗糖尿病溃疡也存在一定的不足,首先,目前关于糖尿病溃疡的临床证候学研究较少;其次,中医药治疗糖尿病溃疡的中药单体、提取物和复方种类繁多,研究不够深入;最后,中医药治疗糖尿病溃疡的机制研究仍处于初步探索阶段,作用机制仍需进一步探索。(5)未来应加强中药药理学和糖尿病溃疡的临床证候学研究,分析中医药治疗糖尿病溃疡的潜在靶点和相关信号通路,充分发挥中医药多靶点、多通路、多层次及多系统的治疗优势,研制出疗效显著、有效成分和作用靶点明确的中药。

血清降钙素原联合超敏C反应蛋白对大叶性肺炎患儿预后的预测价值

目的:探讨降钙素原(PCT)联合超敏C反应蛋白(hs-CRP)对大叶性肺炎患儿预后的预测价值。方法:选择2019年1月—2022年1月于淮安市第二人民医院儿科病房住院的103例大叶性肺炎患儿为研究对象。检测所有患儿血清PCT、hs-CRP水平,根据患儿的预后情况分为治疗不佳组(n=10)与治愈组(n=93),收集患儿的临床资料,以多因素logistic回归分析大叶性肺炎的危险因素,制作受试者操作特征(ROC)曲线,以曲线下面积(AUC)评估血清PCT、hs-CRP对大叶性肺炎预后的预测价值。结果:两组患儿年龄、性别、身高、体重、白细胞计数对比,差异均无统计学意义(P>0.05);治疗不佳组hs-CRP、PCT水平均明显高于治愈组(P<0.05)。多因素logistic回归分析显示,血清PCT、hs-CRP均为大叶性肺炎治疗不佳的危险因素(P<0.05)。血清PCT、hs-CRP单一及联合预测大叶性肺炎治疗不佳的AUC分别为0.805、0.810、0.921,联合预测AUC高于单一预测(P<0.05)。结论:大叶性肺炎患儿血清PCT、hs-CRP水平明显升高,与大叶性肺炎治疗不佳密切相关,且两者在预测大叶性肺炎预后中具有重要价值,PCT、hs-CRP联合预测大叶性肺炎治疗不佳价值更高。

老年脑梗死患者血清ACA、抗β2GP1、Hcy和hs-CRP水平变化及其与疾病严重程度的关系

目的:探讨老年脑梗死患者血清抗心磷脂抗体(ACA)、抗β2糖蛋白1抗体(抗β2GP1)、同型半胱氨酸(Hcy)和超敏C反应蛋白(hs-CRP)水平变化及其与疾病严重程度的关系。方法:选取148例老年脑梗死患者为观察组,根据神经功能缺损(NDS)评分分为轻度组(n=30)、中度组(n=32)及重度组(n=86);另选同期76名体检健康老年人为对照组。比较观察组和对照组及观察组不同病情程度患者的血清ACA、抗β2GP1、Hcy、hs-CRP水平,分析其与疾病严重程度的关系。结果:观察组患者血清ACA、抗β2GP1、Hcy、hs-CRP水平高于对照组(P<0.05)。不同病情程度脑梗死患者血清ACA、抗β2GP1、Hcy、hs-CRP水平比较:重度组>中度组>轻度组(P<0.05)。相关性分析显示,血清ACA、抗β2GP1、Hcy、hs-CRP水平与老年脑梗死患者病情严重程度均呈正相关关系(r=0.636、0.614、0.563、0.571,P<0.05)。ROC曲线分析显示,血清ACA对轻中度与重度的区分有更高的鉴别价值(P<0.05),敏感度和特异性分别为90.70%、87.10%。结论:老年脑梗死患者血清ACA、抗β2GP1、Hcy、hs-CRP水平均升高,且与病情严重程度正相关,可作为鉴别脑梗死严重程度的有效指标。

麦粒灸配合头穴久留针对卒中恢复期非痴呆型认知障碍认知功能及血清标志物的影响

目的 观察五脏俞麦粒灸配合头穴久留针治疗脑卒中恢复期非痴呆型认知障碍的临床疗效及其对血清标志物超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、同型半胱氨酸(homocysteine, Hcy)的影响。方法 将78例脑卒中恢复期合并蒙特利尔认知评估量表(Montreal cognitive assessment, MoCA)评分为18~26分的患者随机分成治疗组40例和对照组38例。治疗组以五脏俞麦粒灸配合头穴久留针治疗,对照组采用单纯头穴久留针治疗。观察两组治疗前后MoCA评分及血清标志物各项指标(hs-CRP、Hcy水平)的变化情况。结果两组治疗后Mo CA评分较同组治疗前均显著提高,血清hs-CRP、Hcy水平均显著降低,差异均具有统计学意义(P<0.05)。治疗组治疗后Mo CA评分明显高于对照组,血清hs-CRP水平明显低于对照组,差异均具有统计学意义(P<0.05)。结论 五脏俞麦粒灸联合头穴久留针的综合疗法能改善脑卒中恢复期非痴呆型认知障碍患者的认知功能,有效降低血清Hcy、hs-CRP水平。

Standford B型主动脉夹层腔内治疗围手术期超敏C反应蛋白等相关指标应用意义的临床研究

目的探讨超敏C反应蛋白(hs-CRP)、D-二聚体(D-D)、降钙素原(PCT)对Standford B型主动脉夹层(TBAD)患者胸主动脉腔内修复术预后的影响。方法选取2017年4月至2022年3月抚州市第一人民医院行胸主动脉腔内修复术(TEVAR)的80例TBAD患者作为研究对象,于术前1 d和术后7 d检测hs-CRP、D-D、PCT水平。根据患者预后分为预后良好组和预后不良组,比较两组患者术前1 d和术后7 d的血清hs-CRP、D-D、PCT水平,分析血清hs-CRP、D-D、PCT水平与患者预后的关联性。结果80例患者中预后良好(预后良好组)63例(78.75%),预后不良(预后不良组)17例(21.25%)。两组患者术后7 d血清hs-CRP、D-D、PCT水平高于本组术前1 d,差异有统计学意义(P<0.05);预后良好组患者术前1 d和术后7 d的血清hs-CRP、D-D、PCT水平低于预后不良组,差异有统计学意义(P<0.05);logistic回归模型分析结果显示,术前1 d血清hs-CRP(β=0.617,OR=1.854,95%CI=1.217~2.696)、D-D(β=0.639,OR=1.895,95%CI=1.841~2.635)、PCT(β=0.554,OR=1.741,95%CI=1.547~3.052)和术后7 d hs-CRP(β=0.892,OR=2.440,95%CI=1.251~4.761)、D-D(β=0.797,OR=2.219,95%CI=1.669~3.141)、PCT(β=0.604,OR=1.829,95%CI=1.058~2.969)水平是接受TEVAR治疗的TBAD患者预后的影响因素,差异有统计学意义(P<0.05)。结论监测围手术期血清hs-CRP、D-D、PCT水平对接受TEVAR治疗的TBAD患者预后判断具有一定的参考价值。

hs-CRP、NT-proBNP及NAR对急性冠状动脉综合征患者诊断价值分析

目的 探讨超敏C反应蛋白(hs-CRP)、氨基末端脑钠肽前体(NT-proBNP)及中性粒细胞与白蛋白比值(NAR)对急性冠状动脉综合征(ACS)患者的诊断价值。方法 选取2020年6月—2022年9月收治的ACS 71例作为研究组,同期健康体检者56例作为对照组,并依照不同疾病类型和血管病变支数将研究组分为ST段抬高型心肌梗死(STEMI)组、非ST段抬高型心肌梗死(NSTEMI)组、不稳定型心绞痛(UAP)组及单支、双支、多支病变组各3个亚组。比较研究组与对照组、不同疾病类型和血管病变支数各3个亚组hs-CRP、NT-proBNP及NAR,探讨hs-CRP、NT-proBNP及NAR单独或联合对ACS的诊断价值。结果 研究组hs-CRP、NT-proBNP及NAR均高于对照组;STEMI组、NSTEMI组和UAP组hs-CRP、NT-proBNP及NAR逐渐降低,单支、双支和多支病变组hs-CRP、NT-proBNP及NAR逐渐升高(P<0.05)。受试者工作特征曲线分析显示,hs-CRP、NT-proBNP和NAR单独或联合诊断ACS的曲线下面积分别为0.820、0.815、0.883及0.914,三者联合诊断ACS的曲线下面积高于单独诊断(P<0.05,P<0.01)。结论 hs-CRP、NT-proBNP及NAR三者联合对ACS的诊断价值较高。

消炎利胆片辅助胆囊切除术治疗急性结石性胆囊炎临床研究

目的:观察消炎利胆片辅助急性结石性胆囊炎的临床效果。方法:以随机数字表法将86例行胆囊切除术治疗的急性结石性胆囊炎患者分为2组,每组43例。对照组行胆囊切除术治疗,观察组在胆囊切除术后给予消炎利胆片治疗。比较2组临床疗效、胃肠功能恢复时间及并发症发生率,比较2组治疗前后血清超敏C-反应蛋白(hs-CRP)、降钙素原(PCT)水平。结果:观察组总有效率95.35%,高于对照组81.40%(P<0.05)。与对照组比较,观察组术后排气、肠鸣音恢复、进食及排便时间更早(P<0.05)。治疗后,2组血清hs-CRP、PCT水平均降低(P<0.05),且观察组低于对照组(P<0.05)。观察组并发症发生率6.98%,低于对照组23.26%(P<0.05)。结论:对急性结石性胆囊炎行胆囊切除术患者给予消炎利胆片治疗,有利于改善术后胃肠功能,减轻机体炎症反应,减少术后并发症,进一步提高临床疗效。

FT3/FT4、hs-CRP/PA、NT-proBNP水平对预测老年急性心力衰竭患者预后的价值

目的 探究游离三碘甲状腺原氨酸/甲状腺素(FT3/FT4)、超敏C反应蛋白/前清蛋白(hs-CRP/PA),及氨基末端脑钠肽前体(NT-proBNP)对老年急性心力衰竭(AHF)预后不良的预测价值。方法 选取2022年3月—2023年3月首都医科大学附属北京潞河医院收治的72例老年AHF患者作为研究组,收集患者FT3/FT4、hs-CRP/PA,及NT-proBNP等临床资料及入院随访一年预后情况,根据预后情况分为预后不良组(n=23)和预后良好组(n=49);另随机抽取72例健康志愿者作为对照组,分析其临床资料及NT-proBNP、FT3/FT4、hs-CRP/PA水平差异,分析其对老年AHF的预测价值。结果 研究组患者的FT3/FT4低于对照组患者,hs-CRP/PA及NT-proBNP高于对照组患者(P<0.05);预后不良组患者FT3/FT4低于预后良好组患者,hs-CRP/PA及NT-proBNP水平高于预后良好组患者(P<0.05)。多因素Logistic回归分析结果显示NT-proBNP、FT3/FT4、hs-CRP/PA水平均为患者预后不良的影响因素(P<0.05)。受试者操作特征曲线分析结果显示,NT-proBNP、FT3/FT4、hs-CRP/PA水平预测老年AHF患者的曲线下面积分别为0.816、0.862、0.713。结论 NT-proBNP、FT3/FT4、hs-CRP/PA与老年AHF患者不良预后有关,3项指标共同使用预测患者预后效能良好。

PCT、hs-CRP、D-D在评估血流感染严重程度及预后不良中的应用价值

目的探讨炎症指标降钙素原(PCT)、超敏C反应蛋白(hs-CRP)、D-二聚体(D-D)在血流感染严重程度及预后不良中的应用价值。方法选取2019年2月至2021年9月该院收治的254例血流感染患者作为研究对象。根据临床资料将其分为菌血症组(81例)、脓毒血症组(109例)、脓毒性休克组(64例)。再根据预后情况将其分为存活组(207例)和死亡组(47例)。检测并比较菌血症组、脓毒血症组和脓毒性休克组,以及存活组和死亡组PCT、hs-CRP及D-D水平。绘制受试者工作特征(ROC)曲线分析PCT、hs-CRP及D-D对血流感染患者预后不良的预测价值。结果脓毒性休克组的PCT、hs-CRP及D-D水平均高于脓毒血症组和菌血症组,且脓毒血症组均高于菌血症组,差异均有统计学意义(P<0.05)。与存活组比较,死亡组中PCT、hs-CRP及D-D水平均明显升高,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,PCT、hs-CRP及D-D单独预测血流感染预后不良的曲线下面积(AUC)分别为0.739、0.769、0.858。PCT联合hs-CRP、hs-CRP联合D-D、PCT联合D-D预测血流感染预后不良的AUC分别为0.787、0.870、0.856。3项指标联合预测血流感染预后不良的AUC为0.870。结论PCT、hs-CRP、D-D可作为预测血流感染患者预后不良的生物标志物,3项指标联合预测血流感染患者预后不良的价值更高。