Relationship of High Sensitivity C-Reactive Protein with Cardiovascular, Diabetic, and Hepatic Biomarkers

Biomarkers are early predictors of various disorders, circulating level of C-reactive protein is a sensitive biomarker of systemic inflammation and may also be associated with the development of diabetic, hepatic, and cardiovascular diseases. In the present study, we aimed to investigate the association between circulating levels of high sensitive C-reactive protein (hs-CRP) and various biomarkers for hepatic, diabetic, and cardiovascular health. The retrospective analysis included 438 individuals who were tested for these panels simultaneously at Vibrant America Clinical Laboratory. The study population included free-living individuals without any preexisting clinical conditions. Among the cardiovascular markers, a positive correlation and significant association was found between high levels of hs-CRP and serum levels of triglycerides (r = 0.0964, p −0.1423, p −0.1216, p < 0.0105) with circulating levels of hs-CRP. Among all the diabetic markers, glucose (r = 0.1547, p < 0.0011) and glycated serum protein (r = 0.1725, p < 0.0003) were positively correlated with circulating hs-CRP. In the hepatic panel, AST, a transaminase that plays a vital role in amino acid metabolism, was found to have a strong positive correlation with hs-CRP (r = 0.2139, p < 0.0001). In conclusion, the results clearly show the association of hs-CRP with diabetic, hepatic, and cardiovascular risk factors indicating its central value as a key marker for several lifestyle-associated disorders.

Correlation of Enhancement Degree on Contrast-enhanced Ultrasound with Histopathology of Carotid Plaques and Serum High Sensitive C-Reactive Protein Levels in Patients Undergoing Carotid Endarterectomy

This study was undertaken to investigate the correlation of the enhancement degree on contrast-enhanced ultrasound(CEUS) with the histopathology of carotid plaques and the serum high sensitive C-reactive protein(hs-CRP) levels in patients undergoing carotid endarterectomy(CEA). Carotid CEUS was performed preoperatively in 115 patients who would undergo CEA, and the enhancement degree of the carotid plaques was evaluated by both the visual semiquantitative analysis and the quantitative time-intensity curve analysis. Serum hs-CRP levels were detected using the particle-enhanced immunoturbidimetric assay also before the operation. Additionally, the carotid plaque samples were subjected to histopathological examination postoperatively. The density of neovessels and the number of macrophages in the plaques were assessed by immunohistochemistry. The results showed that among the 115 patients, grade 0 plaque contrast enhancement was noted in 35 patients, grade 1 in 48 patients and grade 2 in 32 patients. The degree of plaque enhancement, the density of neovessels, the number of macrophages, and the hs-CRP levels were highest in the grade 2 patients. Correlation analysis showed that the enhancement degree of the carotid plaques was closely related to the immunohistochemical parameters of the plaques and the serum hs-CRP levels. It was suggested that the carotid plaque enhancement on CEUS can be used to evaluate the vulnerability of carotid plaques.

Myeloperoxidase and High-Sensitivity C-Reactive Protein for Predicting Major Adverse Cardiovascular Events in Patients with Coronary Heart Disease

Background: Research has shown that high-sensitivity C-reactive protein (hs-CRP) is a major inflammatory marker for prediction of acute coronary syndrome (ACS). Myeloperoxidase (MPO) also plays an important role in atherosclerosis initiation and development. In present study, the major adverse cardiovascular events (MACEs) of patients with coronary heart disease (CHD) were investigated. Methods: MPO, hs-CRP and ACS-related risk factors from 201 ACS (78 AMI and 123 UAP) and 210 non-ACS (84 SAP and 126 non-CHD) patients confirmed by coronary angiography were detected, and the data were analyzed with receiver operating characteristic (ROC) curve and Spearman’s correlation coefficients. MACEs of 285 CHD patients were investigated during the 4-year period follow-up from March 2010 to May 2014. Results: The areas under ROC curve for diagnosing ACS were 0.888 (95% CI 0.843 - 0.933) for MPO, and 0.862 (95% CI 0.815-0.910) for hs-CRP, respectively. There were significantly correlations between MPO and hs-CRP in both ACS and non-ACS groups. Regarding to ACS patients, both MPO and hs-CRP were positively correlated with BMI, TC, TG, LDL-C and Hcy. Prospective study demonstrated that the incidences of MACEs associated significantly with elevated MPO baseline level (yes vs no, OR 7.383, 95% CI 4.095 - 13.309) and high hs-CRP baseline level (yes vs no, OR 4.186, 95% CI 2.469 - 7.097) in CHD patients. Conclusions: The present study provides the epidemiological evidence that elevated baseline MPO and hs-CRP levels are both valuable predictors of MACEs in CHD patients. MPO and hs-CRP would prompt the progression of atherosclerosis and development from SAP to ACS.

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.

Idiopathic Reactive Hypoglycemia: Mechanisms of Onset and Remission with High Protein Low Carbohydrate Diet

Objective: Idiopathic reactive hypoglycemia is defined as early postprandial hypoglycemia occurring on ingestion of high carbohydrate containing meal. Remission ensues with high protein low carbohydrate diet. This study assessed roles of insulin and glucagon in its onset and remission. Methods: Plasma glucose, insulin and glucagon were determined after an overnight fast and repeatedly until 180 minutes on ingestion of 3 meals;100 g glucose;100 g pure protein liquid and mixture of 50 g each at 14 days’ interval. Five adults with IRH and 6 age matched healthy volunteers participated. Results: In IRH, glucose ingestion induced prompt rise in glucose (5.1 ± 0.8 to10.5 ± 1.2 mM/L) followed later by hypoglycemia (2.6 ± 0.4 mM/L). Insulin rose from 7 ± 2 to 90 ± 18 mU/L. Glucagon rose initially (10% ± 2%) from elevated basal concentration (373 ± 57 mU/L) followed by later decline (-43% ± 12%). On protein ingestion, glucose declined followed by a restoration to basal level while both insulin and glucagon rose (28 ± 6 mU/L;148% ± 38%, p < 0.01). However, insulin response was lower and glucagon rise was greater when compared to responses on glucose ingestion (p < 0.01). With mixed meal, glucose (8.2 ± 0.6 mM/L), insulin (65 ± 12 mU/L) and glucagon (48% ± 7%) responses were lesser than rises following glucose ingestion (p < 0.05) and hypoglycemia did not occur. Conclusion: In IRH, initial hyperglycemia on glucose ingestion may be exacerbated by paradoxical glucagon rise and hypoglycemia may be induced by increased insulin and declining glucagon responses. Resolution of hypoglycemia with high protein low carbohydrate diet may be attributed to blunting of insulin response and concurrent glucagon rise.

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.

Clinical application of neutrophil/lymphocyte ratio combined with high sensitive C reactive protein in evaluation of community acquired pneumonia

Objective:To explore the application value of neutrophil/lymphocyte ratio (NLR) combined with high sensitive C reactive protein (hs-CRP) in the evaluation of community acquired pneumonia (CAP). Methods:From November 2015 to October 2016, 58 cases of CAP patients admitted in our department were selected as research objects and were divided into low risk group and high risk group according to the PSI score and CURB-65 standard for evaluation. They were divided into improved group (48 cases) and death group (10 cases) according to prognosis. Hs-CRP was determined by immunoturbidimetric assay, procalcitonin (PCT) by immunofluorescence, NLR by count method of laser scattering, and white blood (WBC) was counted. The differences in WBC, PCT, NLR and hs-CRP between different risk groups were compared, and the correlation was evaluated using Spearman's rank correlation analysis method. The changes in indexes were observed in the improved and death cases. Results:The high risk group had higher NLR, PCT and hs-CRP than low risk group (P<0.05), while no significant difference was found in WBC (P>0.05). No correlation was found between NLR and WBC, while a strong correlation was found between hs-CRP and PCT. The WBC, PCT, NLR and hs-CRP levels were significantly lower in the improved group than the death group (P<0.05). Conclusions:NLR combined with hs-CRP, WBC, and PCT has a good assessment of the severity of CAR, and high levels of NLR, hs-CRP, WBC, and PCT predict the severity of the disease and poor prognosis.

Maraviroc promotes recovery from traumatic brain injury in mice by suppression of neuroinflammation and activation of neurotoxic reactive astrocytes

Neuroinflammation and the NACHT,LRR,and PYD domains-containing protein 3 inflammasome play crucial roles in secondary tissue damage following an initial insult in patients with traumatic brain injury(TBI).Maraviroc,a C-C chemokine receptor type 5 antagonist,has been viewed as a new therapeutic strategy for many neuroinflammatory diseases.We studied the effect of maraviroc on TBI-induced neuroinflammation.A moderate-TBI mouse model was subjected to a controlled cortical impact device.Maraviroc or vehicle was injected intraperitoneally 1 hour after TBI and then once per day for 3 consecutive days.Western blot,immunohistochemistry,and TUNEL(terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling)analyses were performed to evaluate the molecular mechanisms of maraviroc at 3 days post-TBI.Our results suggest that maraviroc administration reduced NACHT,LRR,and PYD domains-containing protein 3 inflammasome activation,modulated microglial polarization from M1 to M2,decreased neutrophil and macrophage infiltration,and inhibited the release of inflammatory factors after TBI.Moreover,maraviroc treatment decreased the activation of neurotoxic reactive astrocytes,which,in turn,exacerbated neuronal cell death.Additionally,we confirmed the neuroprotective effect of maraviroc using the modified neurological severity score,rotarod test,Morris water maze test,and lesion volume measurements.In summary,our findings indicate that maraviroc might be a desirable pharmacotherapeutic strategy for TBI,and C-C chemokine receptor type 5 might be a promising pharmacotherapeutic target to improve recovery after TBI.

Lp-PLA2、hs-CRP和FIB联合检测在急性脑梗死诊断中的应用

目的探讨血浆脂蛋白相关磷脂酶A2(Lp-PLA2)、超敏C反应蛋白(hs-CRP)和纤维蛋白原(FIB)联合检测在急性脑梗死诊断中的临床价值。方法收集我院240例急性脑梗死的住院患者作为研究对象(脑梗组),以100例门诊体检健康人员为对照组,比较两组人群的一般临床数据及检验结果,记录患者入院时的NIHSS评分。分析急性脑梗死患者血浆Lp-PLA2、hs-CRP和FIB水平与其神经功能缺损程度的关系,进行多因素Logistic回归分析确定急性脑梗死的危险因素,利用ROC曲线评估患者血浆Lp-PLA2、hs-CRP和FIB水平对急性脑梗死的诊断价值。结果重度脑梗死患者的Lp-PLA2、hs-CRP和FIB水平均高于轻度及中度脑梗死患者(P<0.05);与对照组比较,脑梗组患者的血浆Lp-PLA2、hs-CRP和FIB水平均显著升高,差异均具有统计学意义(P<0.05)。血浆Lp-PLA2、hs-CRP和FIB水平与急性脑梗死发病风险显著相关(P<0.05)。Lp-PLA2、hs-CRP和FIB 3个指标中,Lp-PLA2的ROC曲线下面积最大,诊断价值最高;Lp-PLA2、hs-CRP和FIB联合检测能显著提高急性脑梗死的诊断效率。结论联合检测Lp-PLA2、hs-CRP和FIB对判断ACI患者神经功能缺损程度具有较高价值。

参松养心胶囊联合沙库巴曲缬沙坦治疗阵发性心房颤动合并慢性心力衰竭对hs-CRP、BNP、AngⅡ及心功能的影响

目的 探讨参松养心胶囊联合沙库巴曲缬沙坦治疗阵发性心房颤动合并慢性心力衰竭对高敏C反应蛋白(High sensitivity C-reactive protein, hs-CRP)、脑钠肽(Brain natriuretic peptide, BNP)、血管紧张素Ⅱ(AngiotensinⅡ,AngⅡ)及心功能的影响。方法 选取100例阵发性心房颤动合并慢性心力衰竭患者,随机分为对照组与观察组,每组50例,对照组在常规治疗基础上给予沙库巴曲缬沙坦口服,观察组在常规治疗基础上给予参松养心胶囊联合沙库巴曲缬沙坦口服治疗,疗程6个月。观察血清hs-CRP、BNP、AngⅡ、左心室射血分数(Left ventricular ejection fraction, LVEF)、左室收缩末期内径(Left ventricular end systolic diameter, LVESD)、左室舒张末期内径(Left ventricular end diastolic diameter, LVEDD)变化。结果 两组治疗前血清hs-CRP、BNP、AngⅡ比较差异无统计学意义(P>0.05),治疗后下降(P<0.05),且观察组低于对照组(P<0.05);两组治疗前LVEF、LVESD、LVEDD比较差异无统计学意义(P>0.05),治疗后LVEF升高(P<0.05),且观察组高于对照组(P<0.05),治疗后LVESD、LVEDD下降(P<0.05),且观察组低于对照组(P<0.05);两组治疗前阵发性心房颤动发作次数、阵发性心房颤动持续时间、心室率比较差异无统计学意义(P>0.05),治疗后下降(P<0.05),且观察组低于对照组(P<0.05);对照组转为持续性心房颤动、心力衰竭恶化、缺血心源性死亡率分别为20.00%、22.00%、4.00%,观察组分别为4.00%、6.00%、0.00%,转为持续性心房颤动、心力衰竭恶化发生率对照组高于观察组(P<0.05);观察组治疗疗效优于对照组(P<0.05)。结论 参松养心胶囊联合沙库巴曲缬沙坦治疗阵发性心房颤动合并慢性心力衰竭有助于促进hs-CRP、BNP、AngⅡ下降,改善患者心功能,改善预后。

冠心病患者PCI术后认知功能改变的相关研究

目的观察经皮冠状动脉介入治疗(PCI)和冠状动脉造影(CAG)对冠状动脉粥样硬化性心脏病(冠心病)患者围术期认知功能的影响,并探讨相应临床化验指标与认知功能障碍的相关性。方法连续收集于北京安贞医院心内科住院治疗的冠心病患者203例为研究对象,其中接受冠状动脉(冠脉)造影55例(CAG组),接受冠脉支架植入治疗148例(PCI组)。于术前及术后6 h,通过“基本认知能力测验”(BCAT)软件系统分别对两组患者术前及术后的加工速度、工作记忆及情景记忆进行检测,同时提取患者术前的相关实验室检查及手术相应临床指标。采用Wilcoxon符号秩检验比较患者的术前及术后认知功能评分的差异,采用皮尔逊相关系数评估各项实验室检查指标及临床指标与术后加工速度、工作记忆及情景记忆得分的相关性,采用多元线性回归评估各检查指标对于术后加工速度、工作记忆及情景记忆得分的影响。结果CAG组患者术前、术后各项认知功能评分均无显著性差异,而PCI组患者在加工速度、情景记忆两个维度上,术后的认知功能评分高于术前评分(P<0.05),在工作记忆维度上无显著性差异(P>0.05)。相关分析表明PCI组患者的年龄与术后工作记忆得分有显著负相关关系(r=-0.258,P<0.01),手术用时与术后情景记忆得分有显著负相关关系(r=-0.206,P<0.05),血清超敏C反应蛋白(hs-CRP)与术后加工速度得分有显著负相关关系(r=-0.273,P<0.01),血清同型半胱氨酸(Hcy)与术前和术后加工速度得分有显著负相关关系(r=-0.288,P<0.01),血清游离三碘甲状腺原氨酸(FT3)与术后情景记忆得分有显著正相关关系(r=0.296,P<0.01)。多元线性回归结果显示,年龄是PCI组患者术后工作记忆得分的独立危险因素(β=-0.238,P<0.05),hs-CRP和Hcy是PCI组患者术后加工速度得分的独立危险因素(β=-0.218~-0.207,P<0.05),FT3是PCI组患者术后情景记忆得分的独立保护因素(β=0.224,P<0.05)。结论冠心病患者接受PCI治疗可加重患者围术期认知功能障碍,应在术前注意筛查患者的认知功能状况并及时进行干预。年龄、手术时间、血清hs-CRP和Hcy水平的增高以及FT3水平的降低是PCI手术患者术后认知功能减低的重要影响因素,血清hs-CRP、Hcy及FT3水平对冠脉介入治疗术后认知功能障碍可能具有早期预测作用。

超敏C-反应蛋白、血清降钙素原及白细胞计数在新生儿感染性疾病中的早期诊断价值

目的研究超敏C-反应蛋白(hs-CRP)、血清降钙素原(PCT)及白细胞(WBC)计数在新生儿感染性疾病的早期诊断价值,为降低临床抗生素使用率及新生儿病死率等提供科学依据。方法将2021年1月—2021年12月本院收治的62例患有感染性疾病的新生儿为病例组,同期同科室收住的50例患新生儿非感染性疾病的病例为对照组,在入院第1天和第7天分别采静脉血对比两组患儿hs-CRP、PCT和WBC的差异,计算hs-CRP、PCT和WBC灵敏度、特异度并绘制ROC曲线。结果入院时病例组hs-CRP、PCT和WBC计数均高于对照组,差异具有统计学意义(P<0.001);入院7天时,病例组hs-CRP、PCT均明显下降,与对照组差异无统计学意义(P>0.05),WBC计数虽较入院时明显下降,但仍较对照组高,差异具有统计学意义(P<0.05);hs-CRP、PCT、WBC计数和hs-CRP+PCT在诊断新生儿感染性疾病的ROC曲线下面积分别是0.954、0.962、0.732和0.985。Hs-CRP+PCT的约登指数最高,曲线下面积最大,其次是PCT、hs-CRP、WBC,差异均具有统计学意义(P<0.05)。结论hs-CRP、PCT和WBC计数在新生儿患有感染性疾病的早期均具有一定的诊断价值,hs-CRP联合PCT有助于早期判断是否使用抗生素。

针刺夹脊穴联合通督调神针刺治疗中风后平衡障碍临床研究

目的:观察针刺夹脊穴联合通督调神针刺治疗中风后平衡障碍的临床效果。方法:将中风后平衡功能障碍患者纳入本次研究,共67例,应用随机数字表法将上述患者分为对照组(34例,常规治疗加通督调神针刺)和试验组(33例,在对照组基础上针刺夹脊穴),两组均治疗4周。治疗后通过使用Berg平衡量表(BBS)、Fugl-Meyer平衡功能评定量表(FMB)、Barthel指数分级法(MBI)、Holden步行功能分级量表(FAC)分别评估患者平衡功能、肢体功能、日常活动能力及步行功能,同时观察生化指标D-二聚体(DD)、同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)变化,并评价整体疗效。结果:治疗4周后,试验组BBS、FMB、MBI及FAC得分分别为(41.56±7.01)、(13.22±1.62)、(70.13±6.92)、(3.84±1.07)分,均显著高于对照组(P<0.05);试验组Hcy、DD、hs-CRP水平分别为(15.42±3.22)μmol/L、(372.46±39.58)μg/L、(5.61±1.03)mg/L,显著低于对照组(P<0.05);试验组总有效率为96.97%,显著优于对照组(P<0.05)。结论:针刺夹脊穴联合通督调神针刺能有效治疗中风后平衡障碍,提高患者肢体功能、日常活动能力及步行能力,改善凝血功能及炎症反应。

超敏C反应蛋白、降钙素原与内毒素对感染性疾病的诊断意义

目的探讨超敏C反应蛋白(hs-CRP)、降钙素原(PCT)与内毒素(ET)对感染性疾病的诊断意义。方法回顾性选取2021年12月至2022年11月杭州市肿瘤医院收治的196例住院患者,根据感染情况分全身感染组10例、局部感染组67例和未感染组119例。比较3组患者性别、年龄、原发病和科室的差异,检测hs-CRP、PCT与ET水平,并对血液hs-CRP、PCT与ET进行相关性分析。结果3组患者原发病、科室比较差异均有统计学意义(均P<0.05),其中局部感染组恶性肿瘤患者占比高于未感染组,差异有统计学意义(P<0.05),全身感染组重症医学科患者占比高于局部感染组、未感染组,局部感染组重症医学科患者占比高于未感染组,差异均有统计学意义(均P<0.05)。与局部感染组、未感染组相比,全身感染组hs-CRP、PCT水平明显增高,差异均有统计学意义(均P<0.05)。全身感染组ET水平高于未感染组,差异有统计学意义(P<0.05)。血液hs-CRP与PCT呈正相关(P<0.01)。结论血液hs-CRP与PCT检测对住院患者全身感染的诊断具有一定意义。临床应重点关注恶性肿瘤患者和危重患者感染情况,及时、合理地调整治疗方案。

维持性血液透析患者心血管并发症发生情况及影响因素分析

目的 探讨维持性血液透析(MHD)患者心血管并发症发生情况及相关影响因素,以期为临床制定防治措施提供依据。方法 回顾性选取2021年11月至2023年11月郑州市第七人民医院收治的206例MHD患者纳入研究,观察其心血管并发症发生情况,根据是否发生心血管并发症分为发生组(50例)、未发生组(156例)。比较两组一般资料、透析相关资料、实验室检查资料[血红蛋白、超敏C反应蛋白(hs-CRP)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、D-二聚体(D-D)、血钾、血钙、血磷、血钠],采用多因素logistic回归分析MHD患者发生心血管并发症的影响因素。结果 MHD患者心血管并发症发生率为24.27%,发生组年龄≥50岁、体重指数≥24.0 kg·m^(-2)、高血压例数占比多于未发生组,透析龄长于未发生组,血红蛋白、血钾水平均低于未发生组,超滤率及hs-CRP水平均高于未发生组(P<0.05);logistic回归分析显示,年龄、体重指数、高血压、超滤率、透析龄及血红蛋白、血钾、hs-CRP水平为MHD患者发生心血管并发症的影响因素(P<0.05)。结论 MHD患者心血管并发症发生率较高,年龄、体重指数、高血压、超滤率、透析龄、血红蛋白、血钾、hs-CRP是MHD患者发生心血管并发症的影响因素,医护人员应根据上述影响因素积极采取相应干预措施,以减少MHD患者心血管并发症的发生。

LMR联合hs-CRP对急性胰腺炎患者并发急性肾损伤的诊断价值

目的探讨淋巴细胞计数与单核细胞计数比值(LMR)联合超敏C反应蛋白(hs-CRP)对急性胰腺炎(AP)患者并发急性肾损伤(AKI)的诊断价值。方法选取2019年10月至2023年11月该院收治的226例AP患者作为研究对象,根据住院期间是否并发AKI分为AKI组(62例)和非AKI组(164例)。采用血液分析仪检测淋巴细胞计数和单核细胞计数,计算LMR;采用特定蛋白免疫分析仪检测hs-CRP水平。收集所有研究对象入院时肝功能、血脂等生化指标。采用Pearson相关分析AP患者LMR与hs-CRP水平的相关性。采用受试者工作特征(ROC)曲线分析LMR联合hs-CRP对AP患者并发AKI的诊断价值。采用多因素Logistic回归分析AP患者并发AKI的影响因素。结果AKI组低密度脂蛋白胆固醇、血肌酐、丙氨酸转氨酶、天冬氨酸转氨酶水平均高于非AKI组,差异均有统计学意义(P<0.05)。AKI组LMR低于非AKI组,hs-CRP水平高于非AKI组,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,AP患者LMR与hs-CRP水平呈负相关(r=-0.645,P<0.001)。LMR联合hs-CRP检测对诊断AP患者并发AKI的曲线下面积(AUC)高于LMR、hs-CRP单独检测的AUC(Z=2.531,P=0.011;Z=3.244,P=0.001)。多因素Logistic回归分析结果显示,血肌酐、LMR、hs-CRP是AP患者并发AKI的影响因素(P<0.05)。结论AP并发AKI患者LMR水平明显降低,hs-CRP水平明显升高,二者联合检测对AP患者并发AKI有一定诊断价值。

血清超敏C反应蛋白、胱抑素C与脓毒性休克患者心功能、肾功能损伤的关系

目的检测脓毒性休克患者血清超敏C反应蛋白(hs-CRP)、胱抑素C(Cys C)水平,探讨其与脓毒性休克患者心功能、肾功能损伤的关系。方法选取2020年5月—2023年12月我院收治的脓毒性休克患者50例,纳入休克组。另选取同期健康体检者48名,纳入参照组。比较2组研究对象hs-CRP、Cys C水平,分析脓毒性休克患者血清hs-CRP、Cys C水平与患者左室射血分数(LVEF)、二尖瓣舒张早期血流峰速(E)/二尖瓣环舒张早期速度(E’)、血浆脑钠肽(BNP)、心肌肌钙蛋白Ⅰ(c TnⅠ)、肾小球滤过率(GFR)及急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分的关系。结果2组研究对象年龄、性别分布、身体质量指数(BMI)及基础疾病患病情况等方面的差异均无统计学意义(P>0.05)。休克组患者的血清hs-CRP水平[(181.01±37.39)mg/L]和血清Cys C水平[(2.62±0.25)mg/L]显著高于参照组[(38.78±10.55)mg/L、(0.96±0.15)mg/L],差异均有统计学意义(P<0.05)。休克组患者的血清hs-CRP水平与LVEF、E/E’、BNP、c TnⅠ水平、APACHEⅡ评分有关(P<0.05),与GFR无相关性(P>0.05);休克组患者的血清Cys C水平与GFR水平、APACHEⅡ评分有关(P<0.05),与LVEF、E/E’、BNP及c TnⅠ水平均无相关性(P>0.05)。结论脓毒性休克患者血清hs-CRP、Cys C水平均显著高于健康体验者,推测其可能与心肌细胞受损、炎症因子水平升高、肾血流量降低等因素有关,可作为评估脓毒性休克患者心、肾功能损伤的参考指标。

经腹联合经会阴超声在克罗恩病管理中的临床价值

目的探讨经腹联合经会阴超声检查在克罗恩病管理中的临床应用价值。方法选取我院收治的克罗恩病患者87例,均应用经腹联合经会阴超声检测末段回肠及结直肠的肠壁厚度、肠壁血流分布及肠外并发症情况,剪切波弹性成像检测肠壁杨氏模量平均值;肠镜检查肠壁炎症程度,并进行简化克罗恩病内镜评分(SES-CD)分期及组织学活检;实验室检查获得血清超敏C反应蛋白。分析各超声参数与肠镜检查结果、血清超敏C反应蛋白的相关性。结果87例克罗恩病患者中,同时进行超声及肠镜检查的肠段共435个,肠镜检查提示缓解期肠段326个(74.9%),活动期肠段109个(25.1%)。其中末段回肠受累者59.8%(52/87)处于活动期。超声提示187个肠段有不同程度肠壁增厚,以末段回肠肠壁增厚最多见(40.2%),且64.4%末段回肠肠壁血流增多,多为LimbergⅡ级(47.1%);肠外并发症以淋巴结可见或增大为主(48.3%)。共96个肠段进行剪切波弹性成像检查,肠壁杨氏模量平均值为0.8~77.1 kPa。相关性分析显示,肠壁厚度、Limberg血流分级均与SES-CD分期呈高度正相关(r=0.796、0.742,均P<0.001);末段回肠肠壁厚度、Limberg血流分级分别与血清超敏C反应蛋白呈中度正相关、弱正相关(r=0.496、0.399,均P<0.05);各肠段肠壁杨氏模量平均值与SES-CD评分无相关性。结论经腹联合经会阴超声能够清晰显示克罗恩病患者的肠道病变及肠外并发症,可以较准确地评估疾病活动度,有一定的临床应用价值。

基于决策曲线分析抗RA33、IL-6及hs-CRP水平对类风湿关节炎治疗反应性的预测价值

目的基于决策曲线分析抗类风湿关节炎-33(抗RA33)、白细胞介素-6(IL-6)及超敏C反应蛋白(hs-CRP)水平对类风湿关节炎(RA)患者治疗反应性的预测价值。方法选取2021年1月至2023年8月该院收治的102例RA患者,收集患者临床资料并检测其血清抗RA33、IL-6及hs-CRP水平。使用甲氨蝶呤与依那西普治疗半年后,根据治疗反应性分为反应良好组与无反应组。采用Pearson相关分析RA患者抗RA33、IL-6、hs-CRP水平与RA疾病活动评分(DAS28)的相关性,多因素Logistic回归分析RA患者治疗无反应的影响因素。绘制受试者工作特征(ROC)曲线,分析抗RA33、IL-6、hs-CRP在RA无反应中的效能。采用决策曲线分析抗RA33、IL-6、hs-CRP单独与联合预测RA患者治疗无反应的净收益情况。结果治疗半年后,反应良好和中度的患者共80例(反应良好组),无效22例(无反应组)。反应良好组病程短于无反应组,DAS28评分低于无反应组(P<0.05)。反应良好组血清抗RA33、IL-6、hs-CRP水平低于无反应组(P<0.05)。Pearson相关分析显示,血清抗RA33、IL-6、hs-CRP水平与DAS28评分均呈负相关(P<0.05)。多因素Logistic回归分析结果显示,DAS28评分及抗RA33、IL-6、hs-CRP水平为RA患者治疗无反应的影响因素(P<0.05)。ROC曲线显示,血清抗RA33、IL-6、hs-CRP单独及联合预测患者治疗无反应的曲线下面积分别为0.729、0.814、0.831、0.948,三者联合的预测价值更高。决策曲线分析显示,在大多合理阈值范围内,血清抗RA33、IL-6、hs-CRP联合预测对RA患者治疗反应性的总体净收益高于单独预测的净收益。结论抗RA33、IL-6、hs-CRP水平与RA患者治疗反应性密切相关,三者联合预测治疗无反应的临床价值及净收益较高。

高分辨率磁共振参数联合血清MMP9、hs-CRP检测预测大脑中动脉粥样硬化性狭窄病人发生急性卒中的价值

目的:分析高分辨率磁共振(HRMRI)参数检测联合血清MMP9、hs-CRP指标对大脑中动脉粥样硬化性狭窄病人急性卒中发生的预测价值。方法:选取183例大脑中动脉粥样硬化性狭窄病人,根据住院期间是否发生急性卒中将其分为急性卒中组89例和无急性卒中组94例。分析狭窄程度及血清MMP9、hs-CRP水平预测大脑中动脉粥样硬化性狭窄病人急性卒中的价值。结果:急性卒中组易损斑块、狭窄程度、Essen卒中风险评分(ESRS)、血清MMP9、hs-CRP水平均高于无急性卒中组(P<0.05);狭窄程度及血清MMP9、hs-CRP水平预测大脑中动脉粥样硬化性狭窄病人发生急性卒中的AUC分别为0.886、0.857、0.634;三者联合预测的AUC为0.923。结论:血清MMP9、hs-CRP联合HRMRI参数检测可提高了评估急性卒中预测的准确性。