High sensitivity C-reactive protein and cardfiac resynchronization therapy in patients with advanced heart failure

Background The data on the prognostic values of high sensitivity C-reactive protein （hsCRP） levels in patients with advanced symp-tomatic heart failure （HF） receiving cardiac resynchronization therapy （CRT） are scarce. The aim of present study was to investigate the association of serum hsCRP levels with left ventricle reverse remodeling after six months of CRT as well as long-term outcome. Methods A total of 232 CRT patients were included. The assessment of hsCRP values, clinical status and echocardiographic data were performed at baseline and after six months of CRT. Long-term follow-up included all-cause mortality and hospitalizations for HF. Results During the mean follow-up periods of 31.3 ± 31.5 months, elevated hsCRP （〉3 mg/L） prior to CRT was associated with a significant 2.39-fold increase （P=0.006） in the risk of death or HF hospitalizations. At 6-month follow-up, patients who responded to CRT showed significant reductions or maintained low in hsCRP levels （–0.5 ± 4.1 mg/L reduction） compared with non-responders （1.7 ± 6.1 mg/L increase, P=0.018）. Com-pared with patients in whom 6-month hsCRP levels were reduced or remained low, patients in whom 6-month hsCRP levels were increased or maintained high experienced a significantly higher risk of subsequent death or HF hospitalizations （Log-rank P〈0.001）. The echocardio-graphic improvement was also better among patients in whom 6-month hsCRP levels were reduced or remained low compared to those in whom 6-month hsCRP levels were raised or maintained high. Conclusions Our findings demonstrated that measurement of baseline and follow-up hsCRP levels may be useful as prognostic markers for timely potential risk stratification and subsequent appropriate treatment strategies in patients with advanced HF undergoing CRT.

The prognostic role of high-sensitivity C-reactive protein in patients with acute myocardial infarction

1 Introduction Inflammation is one of the main mechanisms in the pathogenesis of atherosclerosis,and the interest to the evaluation of inflammatory biomarkers in coronary artery disease(CAD)has been increasing over the last decade.[1,2]Destabilization of chronic artery plaques,which leads to acute coronary syndromes,has been associated with inflammatory status.[1,3]。

Relationship between high sensitivity C-reactive protein and angiographic severity of coronary artery disease

Background Coronary artery disease(CAD)remains a leading cause of morbidity and mortality.Cytokines play a potential role in atherosclerosis pathogenesis and progression.We investigated the association between high sensitive C-reactive protein(hs CRP)and severity of CAD.Methods CAD patients were stratified according to hs CRP cut-off value into high levels hs CRP group(≥8.4 mg/L)and low levels hs CRP group(<8.4 mg/L).Severity of CAD was assessed according to artery stenosis degree and the number of vessel involved.Statistical analysis was performed using Statistical Package for the Social Sciences(SPSS,version 23.0).Results The mean age was 60.3±11.0 years.The level of hs CRP was increased and ranged from 0.2 to 1020.0 mg/L.Biochemical risk factors and severity of CAD didn’t show significant differences between the two groups.In multivariate linear analysis,cardiac troponin I(c Tn I)and serum amyloid A(SAA)were predictors of hs CRP.As shown in receiver operating characteristic(ROC)curve analysis performed in patients with ST-segment elevation myocardial infarction(STEMI)and compared to myonecrosis biomarkers,hs CRP(area under the curve(AUC):0.905;95%CI:0.844-0.966;P<0.001)could be a powerful predictor marker in evaluating the infarct size after myocardial infarction but not better than c Tn I.Conclusions Hs CRP levels were not associated with the severity of CAD but could be useful in the evaluation of myocardial necrosis in patients with STEMI.

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.

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.

EFFECTS OF SIMVASTAIN COMBINED WITH OMEGA-3 FATTY ACIDS ON HIGH SENSITIVE C-REACTIVE PROTEIN, LIPIDEMIA, ANDFIBRINOLYSIS IN PATIENTS WITH MIXED DYSLIPIDEMIA

Objective To evaluate the effects of simvastatin combined with omega-3 fatty acids on high sensitive C-reactive protein(HsCRP), lipidemia, and fibrinolysis in coronary heart disease (CHD) and CHD risk equivalent patients with mixed dyslipi-demia. Methods A randomized, double-blind placebo controlled and parallel group trial was conducted. Patients with CHD and CHD risk equivalents with mixed dyslipidemia were treated with 10 or 20 mg simvastatin for 6-12 weeks. Following with the treatment of patients whose low-density lipoprotein cholesterol (LDL-ch) reaching goal level (< 100 mg/dL) or close to the goal (< 130 mg/dL), while triglyceride (TG) ≥200 mg/dL and < 500 mg/dL, was combined with omega-3 fatty acids (3 g/d) or a placebo for 2 months. The effects of the treatment on HsCRP, total cholesterol (TC), LDL-ch, high-density lipoprotein cholesterol (HDL-ch), TG, lipoprotein (a) [LP (a)], apolipoprotein A1 (apoA1), apolipoprotein B (apoB), plasminogen activator inhibitor-1 (PAI-1), and tissue plasminogen activator (tPA) were investigated. Forty patients finished the study with each group consisting of twenty patients. Results (1) There were significant reductions of HsCRP, TG, TC, and TC/HDL-ch, which decreased by 2.16 ±2.77 mg/L (38.5%), 94.0 ±65.4 mg/dL (31.1%), 13.3 ±22.3 mg/dL (6.3%), 0.78 ±1.60 respectively in the omega-3 fatty acids group (P< 0.01, < 0.001, < 0.05, < 0.05) compared to the baseline. HsCRP and triglyceride reduction were more significant in omega-3 fatty acids group compared to the placebo group (P=0.021 and 0.011 respectively). (2) In the omega-3 fatty acids group, the values and percentage of TG reduction had a significantly positive relation with HsCRP reduction (r=0.51 and 0.45, P=0.021 and 0.047 respectively). Conclusion In CHD and CHD risk equivalent patients with mixed dyslipidemia, dyslipidemia’s therapeutic effect using simvastatin and omega-3 fatty acids may result from not only the combination of lipid adjustment, but also enhancement of their own nonlipid influences.

ASSOCIATION OF INSULIN RESISTANCE AND C-REACTIVE PROTEIN WITH CORONARY ARTERY DISEASE IN PATIENTS WITH NORMAL GLUCOSE TOLERANCE

Objective To examine insulin resistance and high sensitivity C-reactive protein （hsCRP） association with clinical and angiographic severity of coronary artery disease （CAD） in patients with normal glucose tolerance. Methods In 638 consecutive patients with normal glucose tolerance, 221 had atypical chest pain and normal coronary artery （control group）, 279 had stable angina and CAD （SAP group ）, and 138 suffered acute myocardial infarction （ MI group）. The degree of CAD was further divided into borderline lesion （ lumen diameter narrowing 50% - 69% ）, significant 1-, 2- or 3-vessel disease （ luminal diameter narrowing 〉I 70% ）. Fasting serum glucose, insulin and hsCRP levels and lipid profiles were measured, and homeostasis model assessment for insulin resistance （ HOMA-IR ） was calculated. Multivariate analysis was performed to assess risk factors for 3-vessel disease or acute MI. Results Serum hsCRP, lipoprotein （a） levels, and insulin resistance index （IRI） were higher in AMI group than those in SAP and control groups. Serum hsCRP level and IRI were also higher in 3-vessel disease than those in other groups. Multivariate regression analysis revealed that insulin resistance, cigarette smoking, serum hsCRP, and lipoprotein （a） levels were independent risk factors for acute MI. Lipoprotein （ a ） elevation was an independent risk factor for 3-vessel disease. Conclusion Insulin resistance and high serum hsCRP level were associated with occurrence of acute MI and angiographic severity of coronary disease in patients with normal glucose tolerance.

Relationship between coronary atherosclerosis plaque characteristics and high sensitivity C-reactive proteins, interleukin-6

Background The relationship between inflammatory markers and the characteristics of coronary atherosclerosis plaques is uncertain. The aim of the present study was to evaluate the relationship between the characteristics of coronary atherosclerosis plaques and inflammatory markers such as high sensitivity C-reactive proteins （Hs-CRP） and interleukin-6 （IL-6）. Methods All patients suspected of having coronary heart disease （CHD） underwent Siemens 64-slice CT angiography （64-SCTA） to distinguish the quality of plaque of coronary artery lesions. Blood samples were taken to measure levels of serum Hs-CRP and IL-6 in different plaque groups and the control group and compared with the value of 64-SCTA for detection of coronary artery plaque. Results The sensitivity of detecting coronary artery plaque by 64-SCTA was 87.4%, the specificity was 87.1%, the positive predictive value was 82.2%, and the negative predictive value was 91.0%. Comparing the levels of serum Hs-CRP and IL-6 among plaque groups, the mean levels of serum Hs-CRP and IL-6 in three plaque groups were significantly higher than those in the control group （P 〈0.01）. The mean levels of serum Hs-CRP and IL-6 in the soft plaque group and mixed plaque group were significantly higher than those in hard plaque group （P〈0.01）. Plaque burden in the soft plaque group and mixed plaque group was significantly higher than in the hard plaque group （P 〈0.01）, but there was no statistical difference between the soft plaque group and mixed plaque group （P=-0.246）. There was a negative correlation between the CT scale and Hs-CRP and IL-6 levels in the soft plaque group （r= -0.621, P〈0.01, and r= -0.593, P 〈0.01 respectively）. There was a positive correlation between the plaque burden and Hs-CRP and IL-6 levels in the soft plaque group （r=0.579, P〈0.05 and r=0.429, P〈0.05 respectively）. Conclusions 64-SCTA is an effective way to distinguish the different quality of coronary atherosclerosis plaque. Serum Hs-CRP and IL-6 levels can be considered as the indexes to judge the degree of CHD and may reflect the activity of plaque in CHD patients. Thus it is important for clinical diagnosis and risk evaluation of acute coronary syndrome （ACS） patients.

Comparision of high sensitivity C-reactive protein and matrix metalloproteinase 9 in patients with unstable angina between with and without significant coronary artery plaques

Background Inflammation within vulnerable coronary plaques may cause unstable angina by promoting rupture and erosion. C-reactive protein （CRP） is the most reliable and accessible test method for clinical use for identifying coronary artery disease event. Matrix metalloproteinase 9 （MMP-9） is highly over-expressed in the vulnerable regions of a plaque. Our aim was to evaluate the plasma levels of MMP-9 and hsCRP in subjects with both unstable angina and coronary plaques, as well as in those with unstable angina without coronary plaques.

Testosterone replacement therapy improves insulin sensitivity and decreases high sensitivity C-reactive protein levels in hypogonadotropic hypogonadal young male patients

Background Many clinical studies suggest the inverse relationship between testosterone levels and insulin sensitivity in men, however the causative relationship of these two events is still not determined. The purpose of this study was to investigate the effects of testosterone replacement therapy （TRT） on insulin sensitivity, body composition, serum lipid profiles and high sensitivity C-reactive protein （hsCRP） in hypogonadotropic hypogonadal （HH） puberty undeveloped male patients. Methods In this prospectively designed study, we compared homeostasis model assessment of insulin resistance （HOMA-IR）, insulin areas under the curves （AUC） of 3-hour oral glucose tolerance test （OGTT） and other metabolic parameters between 26 HH patients and 26 healthy men. The patients＇ HOMA-IR, insulin AUC, body composition, lipid profiles, hsCRP and other parameters were compared before and after nine-month TRT. Results The average levels of total testosterone （TT） in HH and healthy group were （0.9±0.6） nmol/L and （18.8±3.4） nmol/L, respectively. HOMA-IR in HH group was significantly higher than the healthy group （5.14±5.16 vs 2.00±1.38, P 〈0.005）. Insulin AUC in 3-hour OGTT in HH group was significantly higher than the healthy group （698.6±414.7 vs 414.2±267.5, P 〈0.01）. Fasting glucose level in H H group was significantly higher than control group （（5.1±0.6） mmol/L vs （4.7±0.3） mmol/l, P 〈0.005）. Height, weight and grasp strength of the patients were significantly increased after 9-month TRT. Significant reductions in HOMA-IR （from 5.14±5.16 to 2.97±2.16, P 〈0.01）, insulin AUC （from 698.6±414.7 to 511.7±253.9, P 〈0.01） and hsCRP （from （1.49±1.18） mg/L to （0.70±0.56） mg/L, P 〈0.05） were found after TRT. Serum total cholesterol, LDL-C, HDL-C and triglyceride were all decreased, albeit with no significant difference compared to the level prior to TRT. Conclusions HOMA-IR, insulin AUC and fasting glucose level in HH young male patients were significantly higher than those of the control group, which suggests that low level of testosterone in male adolescents might be a risk factor for insulin resistance. TRT can significantly improve patients＇ insulin sensitivity and suppress serum hsCRP, which in return suggests that TRT may prevent the HH patients from developing diabetes mellitus and cardiovascular diseases （CVD） in future.

Elevated high sensitive C-reactive protein and apelin levels after percutaneous coronary intervention and drug-eluting stent implantation

Objective:Percutaneous coronary intervention(PCI) triggers an acute inflammatory response,while sirolimus is known to have anti-inflammatory properties;the inflammatory system response to PCI after sirolimus-eluting stent placement remains unclear.The purpose of this study is to determine the changes in high sensitive C-reactive protein(hs-CRP) and apelin after PCI procedure and drug-eluting stent implantation in patients with and without reduced left ventricular systolic function.Methods:Forty-eight consecutive patients undergoing PCI at the Beijing Anzhen Hospital between July and September 2006 were recruited.Sirolimus-eluting stents were employed in all patients.Blood samples were drawn immediately before and 24 h after the procedure.Plasma hs-CRP and apelin levels were determined by enzyme immunoassay.Results:Paired t-test revealed a significant increase in both hs-CRP and apelin post-procedure(P=0.006 and P<0.0001,respectively).Patients with reduced left ventricular ejection fraction(LVEF) had significantly lower baseline apelin levels compared to those with normal ventricular function [(46.8±10.8) vs.(72.0±8.4) pg/ml,P<0.001].However,apelin increased to a level similar to the level of those with normal left ventricular systolic function 24 h after the PCI procedure [(86.7±11.6) vs.(85.1±6.1) pg/ml,P=0.72].Conclusions:hs-CRP and apelin levels increased after PCI and sirolimus-eluting stent implantation.Patients with impaired left ventricular systolic function had significantly lower baseline apelin levels,which increased significantly after PCI.

Matrix γ-carboxyglutamate protein and Fetuin-A, in wet type age-related macular degeneration

AIM: To evaluate the high sensitivity C-reactive protein(hs CRP), Fetuin-A and matrix γ-carboxyglutamate protein(MGP) as the main factors for vascular calcification and inflammation in serum of patients with advanced age-related macular degeneration(ARMD) in comparison to healthy controls. METHODS: The subjects were 40 patients with choroidal neovascularization(CNV) having a mean age of70.9 ±9.1y and a matched group of 49 apparently healthy control subjects. The ARMD was diagnosed using a slitlamp with superfield lens, fundus photography and fluorescein angiography. Measurement of hs CRP was done by nephelometry method. Levels of Fetuin-A and MGP were measured by enzyme-linked immunosorbent assay(ELISA) technique.RESULTS: hs CRP [0.45(0.07-2.63) mg/L vs 0.25(0.03-1.2) mg/L, P =0.02)] and Fetuin-A levels(50.27 ±5.04 vs44.99±10.28 ng/m L, P =0.009) were higher in the patients than in the control groups. We could not find significant difference in MGP level between two groups(P =0.08).There was not a significant correlation between MGP with Fetuin-A and hs CRP among the patients(P =0.7, P =0.9respectively). A significant negative correlation of hs CRP with Fetuin-A was observed in both case and control groups(P =0.004, r =-0.33 and P =0.001, r =-0.54,respectively).CONCLUSION: Although our study shows that serum hs CRP and Fetuin-A is increased in CNV patients as well as negatively correlated with both study groups, their direct role on pathogenesis of ARMD required future studies.

Role of plasma C-reactive protein in predicting in-stent restenosis in patients with stable angina after coronary stenting

Background The role of plasma high sensitivity C-reactive protein （hs-CRP） in in-stent restenosis （ISR） remains controversial. We investigated plasma hs-CRP level at both admission and follow-up in patients with stable angina （SA）after successful coronary stenting in order to clarify the predictive value of hs-CRP for ISR.Methods We summarized 303 consecutive chronic SA patients with coronary drug-eluting stent （DES） implantation.The ISR was analyzed by quantitative coronary analysis （QCA） at a mean follow-up of 8 months, and the patients were divided into two groups according to the detected ISR as ISR group （n=48） and non-ISR group （n=255）. Plasma hs-CRP was examined at both admission and 8-month follow-up in all patients, standard medication continued throughout the investigation period.Results QCA presented that 48 patients （15.8%） suffered from ISR at follow-up. The basic clinical characteristics were similar between the two groups, while plasma hs-CRP was higher in ISR group than that in non-ISR group at both admission and follow-up, P 〈0.001 respectively. Multivariate regression analysis indicated that plasma hs-CRP level at either admission or follow-up could independently predict ISR occurrence （OR=5.581, 95% Cl 2.532-12.302, P〈0.001and OR=6.299, 95% CI 2.722-14.577, P 〈0.001, respectively）.Conclusions Our data indicate that plasma hs-CRP level may independently predict ISR at both admission and follow-up in SA patients with coronary DES implantation, which implies that a chronic, sustained systemic inflammatory response might be involved in ISR pathogenesis.

小剂量长疗程补充α-骨化醇对2型糖尿病患者胰岛β细胞功能和糖脂代谢及抗炎作用影响的随机对照研究

目的维生素D被认为在2型糖尿病(T2DM)患者的发病及糖代谢过程中发挥重要作用,本研究旨在观察小剂量长疗程补充α-骨化醇对T2DM患者胰岛细胞功能、胰岛素抵抗、糖脂代谢以及抗炎作用的影响。方法选取2011年2月—2013年10月于江苏省老年医院就诊的T2DM患者92例为研究对象。根据性别相同,年龄、病程相近原则,将患者随机分为治疗组和对照组,各46例。两组患者均接受口服降糖药物治疗,治疗组添加α-骨化醇0.25μg,1次/d,口服;对照组添加安慰剂(膳食纤维)0.25μg,1次/d,口服。干预措施持续18个月,对患者和研究实施者采用盲法。检测基线及干预3、6、12、18个月时血清维生素D、C肽、空腹胰岛素、糖化血红蛋白(HbA_(1c))、极低密度脂蛋白胆固醇(VLDL-C)、低密度脂蛋白胆固醇(LDL-C)、脂蛋白a〔Lp(a)〕、血钙、血磷、超敏C反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)水平。结果基线时,两组体质指数(BMI)、维生素D、C肽、稳态胰岛素抵抗指数(HOMA-IR)、HOMA-β细胞功能指数、Hb A1c、VLDL-C、LDL-C、Lp(a)、血钙、血磷、hs-CRP、Hcy水平比较,差异均无统计学意义(P>0.05)。干预3个月时,治疗组HOMA-IR低于对照组,差异有统计学意义(P<0.05)。干预6个月时,治疗组C肽水平、HOMA-β细胞功能指数高于对照组,HOMA-IR、hs-CRP水平低于对照组,差异均有统计学意义(P<0.05)。干预12个月时,治疗组C肽水平、HOMA-β细胞功能指数高于对照组,HOMA-IR、HbA_(1c)、VLDL-C、LDL-C、hs-CRP、Hcy水平低于对照组,差异均有统计学意义(P<0.05)。干预18个月时,治疗组C肽、HOMA-β细胞功能指数高于对照组,HOMA-IR、HbA_(1c)、VLDL-C、LDL-C、hs-CRP、Hcy水平低于对照组,差异均有统计学意义(P<0.05)。结论小剂量长疗程补充α-骨化醇有助于促进T2DM患者胰岛素分泌,改善胰岛β细胞功能、胰岛素抵抗及糖脂代谢,降低炎性因子水平。

血清降钙素原在烧伤患者细菌性感染诊断中的价值

目的探讨血清降钙素原(PCT)在烧伤患者细菌性感染诊断中的临床价值。方法 169例烧伤患者经血培养、分泌物和穿刺液培养等病原学检查确认细菌性感染96例,非细菌性感染73例,2组患者同时进行PCT、WBC和超敏C反应蛋白(hsCRP)检查,比较这3项指标在细菌性感染诊断中的价值,并进一步研究PCT浓度水平与烧伤程度的关系。结果细菌性感染组烧伤患者血清PCT、WBC和hs-CRP浓度水平明显高于非细菌性感染组(P<0.05)。PCT诊断细菌性感染敏感性为90.63%,特异性为89.04%,阳性预测值为91.58%,阴性预测值为87.84%,PCT对细菌性感染的诊断效能明显高于其他两项炎症指标,PCT的浓度水平与烧伤患者的烧伤程度成正相关。结论细菌性感染的烧伤患者血清PCT、WBC和hs-CRP水平明显升高,PCT作为诊断细菌性感染标志物具有更好的敏感性及特异性,优于WBC和hs-CRP两项炎症指标。

低通量聚砜膜进行血液透析对患者血清炎症因子、C反应蛋白、脂蛋白(a)和β2微球蛋白的影响

目的研究低通量聚砜膜对慢性血液透析患者血清炎症因子、超敏C反应蛋白(hsCRP)、脂蛋白(a)[Lp(a)]和β2微球蛋白(β2MG)水平的影响。方法以病情稳定、长期行血液透析的27例患者为研究对象,留取透析前、透析中2h、透析后血清和透析水样,测定血清Lp(a)、β2MG、白细胞介素(IL)-1β、IL-6和hsCRP水平,并测定透析水样中的内毒素水平。结果透析前、透析中2h和透析后透析水样中的内毒素水平及患者血清IL-1β、IL-6、hsCRP、Lp(a)和β2MG水平差异均无统计学意义(P>0.05)。结论低通量聚砜膜对血液透析患者一次治疗过程中的血清炎症因子、hsCRP、Lp(a)和β2MG水平没有影响。

炎症因子IL-6、IL-10及hs-CRP与老年高血压患者认知功能障碍的关系研究

目的探讨白细胞介素-6(interleukin 6,IL-6)、白细胞介素-10(interleukin 10,IL-10)及高敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)与老年高血压患者认知功能障碍的关系。方法本研究纳入300例年龄≥60岁老年高血压患者,收集患者年龄、性别等一般资料及空腹血糖、总胆固醇、甘油三酯、低密度脂蛋白、尿酸、hs-CRP、IL-6、IL-10等实验室指标,采用简易精神状态量表(mini-mental state examination,MMSE)进行认知功能评估,并分析血清炎症因子水平与老年高血压患者MMSE评分的相关性。结果本研究收集的300例老年高血压患者,平均年龄(78.3±5.1)岁,在老年高血压患者中,伴认知功能障碍组炎性因子hs-CRP、IL-6、IL-10水平显著高于不伴认知功能障碍组,差异有统计学意义(P<0.05)。IL-6水平与MMSE评分呈负相关性。结论在老年高血压患者中,炎性因子hs-CRP、IL-6、IL-10水平与认知功能障碍存在相关关系,其中血清IL-6水平可能反映老年高血压患者认知障碍的严重程度。

超敏C反应蛋白与急性心肌梗死的相关性探讨

目的探讨超敏C反应蛋白(hs-CRP)与急性心肌梗死的关系。方法收集2008年8月至2011年9月收住我院的52例冠心病患者的病历资料。其中心绞痛29例,急性心肌梗死23例,所有患者入院后当天检测hs-CRP。结果心肌梗死患者hs-CRP为(18.4±4.8)mg/L,明显高于心绞痛患者的(11.3±3.1)mg/L,差异有统计学意义(P<0.05)。hs-CRP判断急性心肌梗死ROC曲线下面积A(hs-CRP)=0.898,其判断急性心肌梗死的诊断阈值为23.2 mg/L,相应的敏感度(Se)为0.77,特异度(Sp)为0.89。结论 hs-CRP可判断急性心肌梗死的发生,其阈值为23.2 mg/L。

超敏C反应蛋白检测在儿童细菌和支原体感染中的应用研究

目的探讨超敏C反应蛋白(hsCRP)在儿童细菌性感染和支原体感染中的检测水平,以提高hsCRP检测的应用价值。方法选取2010年3月至2015年3月的101例感染患儿作为研究对象,根据血液学和细菌培养情况分成细菌感染组和支原体感染组,分别为67、34例。另外,选取同期健康的儿童体检者50例作为对照组。对上述幼儿抽取静脉血,分别检测hsCRP、白细胞(WBC)、中性粒细胞百分比(NEUT%)水平。结果细菌感染组hsCRP、WBC水平及异常率均高于支原体感染组和对照组(P<0.05);支原体感染组NEUT%及其异常率高于其他两组(P<0.05)。治疗后细菌感染组hsCRP、WBC水平和异常率均低于治疗前,差异均有统计学意义(P<0.05);hsCRP对细菌感染诊断的最大受试者工作特征曲线(ROC)曲线下面积为0.68,灵敏度、特异度分别为89.9%、88.3%。结论 hsCRP水平检测对儿童细菌感染有早期诊断价值,其检测可以动态地反映治疗效果。