C-反应蛋白与急性冠脉综合征

C-反应蛋白(CRP)是一种会对肺炎球菌荚膜C多糖物质反应的急性期反应蛋白,参与全身或局部为炎性反应。综合近年来的研究提示,CRP升高不仅是冠心病的危险因子,而且是预测心血管高危事件的重要标志。高CRP的心血管危险可经阿司匹林和他汀类药物治疗而减少。

C-反应蛋白在小儿感染性疾病中的诊断价值探讨

目的通过C-反应蛋白（CRP）与白细胞计数（WBC）的对比分析，探讨其在小儿感染性疾病中的诊断价值和临床意义。方法采用免疫比浊法对我院住院治疗的362例小儿感染性疾病的患者进行CRP测定，同时测定WBC。结果CRP、WBC同时升高66例，占18．23％；CRP升高、WBC正常48例，1326％；CRP、WBC均正常者163例，占45．03％；CRP正常、WBC增高85例。占23．48％。结果显示，在小儿感染性疾病时，CRP升高与WBC升高有相关性，两者同时升高对细菌性感染有重要提示意义，而CRP的增高更有早期诊断价值。结论C-反应蛋白在小儿感染性疾病中有早期诊断价值．与WBC联合检测更有，临床指导意义。

急性脑梗死患者血浆C-反应蛋白水平研究

目的:探讨急性脑梗死患者血浆C-反应蛋白(CRP)水平与其病情严重程度之间的关系。方法:对40例脑梗死患者发病后24小时内的血CRP进行测定,并进行神经功能缺损评分。结果:脑梗死后24 h血CRP浓度即开始升高,CRP在脑栓死患者、动脉血栓性脑梗死患者之间差异无显著性,两者较腔隙性脑梗死患者血CRP增高(P<0.01)。病情越重血浆CRP水平越高。结论:血浆CRP是判断脑梗死病情轻重和预后的特异性指标,适时终止或减轻炎症反应损害,可以降低脑梗死的死亡率及并发多脏器衰竭的危险。

C-反应蛋白在小儿急性上呼吸道感染中应用价值分析

目的探讨C-反应蛋白在小儿急性上呼吸道感染中应用价值分析。方法对2010年5月至2011年5月来我院264例急性上呼吸道感染的而住院的患儿,按照感染的类型分为细菌感染组和病毒感染组,并且选择60名健康儿童作为对照组,检验并分析3组儿童的血清CRP和WBC。结果细菌组CRP水平明显高于病毒感染组和健康对照组,差异有显著的统计学意义(P<0.01),细菌感染组CRP阳性率为70.49%,明显高于病毒感染组的4.23%,差异有显著的统计学意义,P<0.01。WBC异常率细菌感染组也明显高于病毒感染组,差异有显著的统计学意义,P<0.01,但是CRP在细菌感染组的阳性率高于WBC,并且在病毒感染组的阳性率低于WBC,进一步研究显示经过抗生素治疗后,CRP水平逐渐下降。结论 CRP测定对儿童呼吸道感染感染类型具有较高的应用价值,并且是判断治疗效果较好的指标。

c-反应蛋白对病毒性心肌炎的诊断价值

目的:探讨c-反应蛋白对病毒性心肌炎的诊断价值。方法:收集48例病毒性心肌炎患者(治疗组)和同期健康志愿者48名(对照组)。分别于1、3、7和14天空腹抽取不抗凝静脉血4mL,健康体检者于体检当日清晨抽取不抗凝静脉血4mL。CRP检测采用快速免疫消浊比浊法。具体操作由检验科同一医师严格按操作说明书进行。结果:观察组患者入院第1天时血清中CRP含量最高,经对症治疗后血清中CRP含量逐渐下降,于治疗第7天时可恢复至正常。血清中CRP的含量入院第1天的检测结果与第3天的检测结果相比有显著差异(P<0.05);入院第1天的检测结果与第7天、第14天的检测结果相比有极显著差异(P<0.01)。对照组第1、3、7、14天血清中CRP水平均在正常范围内,且4次检测结果无明显差异。血清中CRP含量入院第1天时两组相比有极显著性差异(P<0.01),入院第3天时相比有显著性差异(P<0.05),入院第7和14天两组相比无明显差异(P>0.05)。结论:综上所述,在病毒性心肌炎发病早期CRP可作为其诊断指标,且心肌损害的程度呈正相关。

C-反应蛋白在急性心肌梗死早期的诊断价值

目的研究血清中C-反应蛋白（CRP）浓度在急性心肌梗死早期的改变。方法采用免疫比浊法对51例急性心肌梗死患者入院时及治疗3周以后的血清标本进行CRP浓度检测，同时检测50例健康者的血清CRP浓度，进行对比分析。结果在急性心肌梗死早期，血清CRP浓度很快上升。3周左有逐步恢复正常。结论急性心肌梗死患者血清CRP水平是较敏感的诊断指标，对急性心肌梗死的快速诊断及病情预测有重要临床价值.

C-反应蛋白测定应用于小儿肺炎临床诊断的价值分析

探讨临床收治的小儿肺炎病例在临床诊断时对C-反应蛋白测定临床价值。方法:选择小儿肺炎60例,均于2017年2月至2018年2月期间由我院儿科收治,其中共对细菌性肺炎确诊30例,按观察组A进行设置,对病毒性肺炎确诊30例,按观察组B进行设置,同期选择健康体检的患儿30例,设为对照组,对比3组C-反应蛋白检测情况。结果:观察组A、观察组B患儿C-反应蛋白测定结果和白细胞计数测定结果均明显高于对照高,具统计差异(P<0.05)。且观察组A明显高于观察组B(P<0.05)。观察组A患儿中,C-反应蛋白阳性检出率经统计为90%;对照组8例,占26.7%,对比具显著统计学差异(P<0.05)。结论:小儿肺炎应用C-反应蛋白予以测定,可为细菌性和病毒性肺炎的鉴别诊断提供有力参考依据,具非常重要的应用价值。

急性脑梗死患者C-反应蛋白水平与预后的关系

探讨急性脑梗死患者血清C-反应蛋白(CRP)与病情及预后的关系。

C-反应蛋白与急性脑血管病的相关性研究

探讨C-反应蛋白(CRP)与急性脑血管的相关性。

C-反应蛋白与冠心病的临床相关性

目的探讨不同类型冠心病患者C-反应蛋白(CRP)的水平及其临床意义,为临床早期发现、早期预防冠心病提供新的检测手段。方法对比不同类型冠心病患者及正常人群中的CRP水平,探讨CRP与冠心病的关系。结果冠心病组患者CRP含量高于对照组(P<0.05),且稳定性型心绞痛、不稳定型心绞痛及急性心肌梗死患者的CRP水平依次升高(P均<0.01)。结论冠心病患者血清CRP水平明显升高,并与疾病的严重程度密切相关,其检测有助于冠心病的早期预测和诊断。

人血清c─反应蛋白的生物素─抗生物素蛋白酶联免疫吸附测定法

人血清ｃ─反应蛋白的生物素─抗生物素蛋白酶联免疫吸附测定法宋丽萍，汪经，高艳琴（上海医科大学基础医学院化学教研室２０００３２）关键词ｃ－反应蛋白；生物素；抗生物素蛋白；酶联免疫吸附测定法ｃ－反应蛋白（ＣＲＰ）是一种急性相蛋白质，正常人血液中含量甚微，...

高级氧化蛋白产物在急性冠脉综合征患者的表达及其临床意义

目的探讨高级氧化蛋白产物(AOPP)在急性冠脉综合征患者的表达及其临床意义。方法急性冠脉综合征患者208例,其中不稳定心绞痛(UAP)患者78例,急性非ST段抬高心肌梗死(NSTEMI)患者62例,ST段抬高心肌梗死(STEMI)患者68例,以及年龄、性别相匹配的稳定性心绞痛(SAP)患者65例(对照组),接受冠脉造影证实冠心病诊断。采用分光光度计法测定所有患者的血清AOPP浓度,采用乳胶凝集反应法测定血清高敏C-反应蛋白(hs-CRP)浓度。单因素方差分析法比较各组血清AOPP和血清hs-CRP浓度的差异,血清AOPP浓度和血清hs-CRP浓度之间的关系作Spearman相关分析。结果ACS各组患者AOPP浓度和hs-CRP浓度显著高于SAP组(均P<0.05)。ACS组中急性心肌梗死患者AOPP浓度和CRP浓度显著高于不稳定心绞痛患者(均P<0.05),且急性ST段抬高心肌梗死患者AOPP浓度和CRP浓度显著高于急性非ST段抬高心肌梗死患者(均P<0.05)。血清AOPP浓度与血清CRP呈高度正相关(r=0.648,P<0.01)。结论AOPP参与了ACS的发病过程,并可能与炎症反应互相促进。AOPP浓度异常增高是反映ACS患者体内存在严重氧化应激状态的重要指标,对急性冠脉综合征患者的诊断和临床病情评估有重要的参考意义。

血清蛋白电泳分布规律的相关因素及不同病种图谱的变化

目的了解不同病种血清蛋白电泳谱的变化情况及某些指标与血清蛋白电泳谱存在的相关性。方法该院采用法国SEBIA琼脂糖电泳技术测定3种具有代表性病种的120例患者标本血(40例肾病综合征,40例肝硬化患者,40例临产患者)、40例正常健康人群(对照组)标本血,测定血清蛋白电泳、血清蛋白、纤维蛋白原、β2-微球蛋白及超敏C-反应蛋白进行比对和相关性的探讨。结果实验组的3组数据较对照组在α1、α2、β球蛋白百分比分布上均有差异有统计学意义(P<0.001),且实验组中不同病种的纤维蛋白原、β2-微球蛋白及超敏C-反应蛋白较对照组增高或减低。结论经过与对照组数据的比较,α1、α2、β球蛋白、γ球蛋白百分比在不同疾病上具有不同程度的变化,且β、γ球蛋白比例增加与β、γ球蛋白中的纤维蛋白原、β2-微球蛋白、超敏C-反应蛋成分的变化存在相关性。

C-reactive protein,procalcitonin,interleukin-6,vascular endothelial growth factor and oxidative metabolites in diagnosis of infection and staging in patients with gastric cancer

AIM:The current study was to determine the serum/pLasma levels of VEGF,IL-6,malondialdehyde (MDA),nitric oxide (NO),PCT and CRP in gastric carcinoma and correlation with the stages of the disease and accompanying infection. METHODS:We examined the levels of serum VEGF,IL-6, PCT,CRP and plasma MDA,NO in 42 preoperative gastric cancer patients and 23 healthy subjects.There were infection anamneses that had no definite origin in 19 cancer patients. RESULTS:The VEGF levels (mean±SD; pg/mL) were 478.05±178.29 and 473.85±131.24 in gastric cancer patients with and without infection,respectively,and these values were not significantly different (P>0.05).The levels of VEGF, CRP,PCT,It-6,MDA and NO in cancer patients were significantly higher than those in healthy controls and the levels of CRP,PCT,It-6,MDA and NO were statistically increased in infection group when compared with non- infection group (P<0.001). CONCLUSION:Although serum VEGF concentrations were increased in gastric cancer,this increase might not be related to infection.CRP,PCT,IL-6,MDA and NO have obvious drawbacks in the diagnosis of infections in cancer patients. These markers may not help to identify infections in the primary evaluation of cancer patients and hence to avoid unnecessary antibiotic treatments as well as hospitalization. According to the results of this study,IL-6,MDA,NO and especially VEGF can be used as useful parameters to diagnose and grade gastric cancer.

Adjusting CA19-9 values to predict malignancy in obstructive jaundice:Influence of bilirubin and C-reactive protein

AIM:To find a possible relationship between inflammation and CA19-9 tumor marker by analyzing data from patients with benign jaundice(BJ) and malignant jaundice(MJ).METHODS:All patients admitted for obstructive jaundice,in the period 2005-2009,were prospectively enrolled in the study,obtaining a total of 102 patients.On admission,all patients underwent complete standard blood test examinations including C-reactive protein(CRP),bilirubin,CA19-9.Patients were considered eligible for the study when they presented obstructive jaundice confirmed by instrumental examinations and increased serum bilirubin levels(total bilirubin > 2.0 mg/dL).The standard cut-off level for CA19-9 was 32 U/mL,whereas for CRP this was 1.5 mg/L.The CA19-9 level was adjusted by dividing it by the value of serum bilirubin or by the CRP value.The patients were divided into 2 groups,MJ and BJ,and after the adjustment a comparison between the 2 groups of patients was performed.Sensitivity,specificity and positive predictive values were calculated before and after the adjustment.RESULTS:Of the 102 patients,51 were affected by BJ and 51 by MJ.Pathologic CA19-9 levels were found in 71.7% of the patients.In the group of 51 BJ patients there were 29(56.9%) males and 22(43.1%) females with a median age of 66 years(range 24-96 years),whereas in the MJ group there were 24(47%) males and 27(53%) females,with a mean age of 70 years(range 30-92 years).Pathologic CA19-9 serum level was found in 82.3% of MJ.CRP levels were pathologic in 66.6% of the patients with BJ and in 49% with MJ.Bilirubin and CA19-9 average levels were significantly higher in MJ compared with BJ(P = 0.000 and P = 0.02),while the CRP level was significantly higher in BJ(P = 0.000).Considering a CA19-9 cut-off level of 32 U/mL,82.3% in the MJ group and 54.9% in the BJ group were positive for CA19-9(P = 0.002).A CA19-9 cut-off of 100 U/mL increases the difference between the two groups:35.3% in BJ and 68.6% in MJ(P = 0.0007).Adjusting the CA19-9 value by dividing it by serum bilirubin level meant that 21.5% in the BJ and 49% in the MJ group remained with a positive CA19-9 value(P = 0.003),while adjusting the CA19-9 value by dividing it by serum CRP value meant that 31.4% in the BJ group and 76.5% in the MJ group still had a positive CA19-9 value(P = 0.000004).Sensitivity,specificity,positive predictive values of CA19-9 > 32 U/mL were 82.3%,45% and 59.1%;when the cutoff was CA19-9 > 100 U/mL they were,respectively,68.6%,64.7% and 66%.When the CA19-9 value was adjusted by dividing it by the bilirubin or CRP values,these became 49%,78.4%,69.4% and 76.5%,68.6%,70.9%,respectively.CONCLUSION:The present study proposes CRP as a new and useful correction factor to improve the diag-nostic value of the CA19-9 tumor marker in patients with cholestatic jaundice.

Significance of preoperative C-reactive protein as a parameter of the perioperative course and long-term prognosis in squamous cell carcinoma and adenocarcinoma of the oesophagus

AIM： C-reactive protein （CRP） is an acute-phase reactant and a known indicator of the malignant potential of the tumour. The aim of this study was to investigate the significance of preoperative CRP as a parameter of the perioperative course and long-term prognosis in patients with squamous cell carcinoma and aclenocarcinoma of the oesophagus. METHODS： Serum CRP was determined preoperatively in 291 of 371 patients undergoing oesophagectomy for cancer from December 1989 to March 2004. Median patient age was 59 （28-79） year, 82.5% of patients were males. Squamous cell carcinoma was diagnosed in 151 （51.9%） and aclenocarcinoma in 122 patients. Transhiatal oesophagectomy was clone in 151 （51.9%） patients and 134 （46.0%） patients underwent the abclominothoracic procedure. RESULTS： In 127 （43.6%） patients the preoperative serum CRP concentration was within the normal range （〈 5 mg/clL）, elevated CRP levels were measured in 164 （56.4%） patients. Tumour extension （P 〈 0.0005） and the number of lymph nodes affected by metastatic spread （P = 0.015） were significantly increased in the group with elevated CRP levels. Among the perioperative parameters both the number of blood transfusions （P = 0.006） and the general complication rate （P = 0.002） were higher in patients with elevated preoperative CRP levels. The long-term survival rate of 13.6 （0-109.8） mo was poorer in the group with elevated CRP levels compared to 18.9 （0-155.4） mo in the group with normal CRP levels （log-rank test： P = 0.107）. Multivariateanalysis with backward variables selection identified preoperative CRP as an independent prognostic factor of the long-term prognosis in patients with oesophageal carcinoma, with a hazard ratio of 1.182 （95% confidence interval： 1.030-1.356）. CONCLUSION： The preoperative serum CRP-level is an easily determined independent prognostic marker in patients with squamous cell carcinoma and adenocarcinoma of the oesophagus.

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.

Associations of big endothelin-1 and C-reactive protein in atrial fibrillation

Background Atrial fibrillation （AF） is associated with inflammation and endothelial dysfunction. However, the association between inflammation （as indexed by high-sensitivity C-reactive protein, hs-CRP） and endothelial function [as indexed by big endothelin-1 （ET-1）] in AF patients remains unclear. Methods We enrolled 128 patients with lone AF, among which 83 had paroxysmal AF, and 45 had persistent AF. Eighty-two age- and gender-matched controls of paroxysmal supraventricular tachycardia without AF history were evaluated. Plasma hs-CRP, big ET-1 levels and other clinical characteristics were compared among the groups. Results Patients with persistent AF had higher hs-CRP concentrations than those with paroxysmal AF （P 〈 0.05）, both groups had higher hs-CRP level than controls （P 〈 0.05）. Patients with persistent AF had higher big ET-1 level than those with paroxysmal AF, although the difference did not reach the statistical significance （P 〉 0.05）, and both groups had higher big ET-1 levels than controls （P 〈 0.05）. Multiple regression analyses revealed hs-CRP as an inde- pendent determinant of AF （P 〈 0.001）. Further adjusted for big ET-1, both big ET-1 and hs-CRP were independent predictors for AF （P 〈 0.001）, but the odds ratio for hs-CRP in predicting AF attenuated from 8.043 to 3.241. There was a positive relation between hs-CRP level and big ET-1 level in paroxysmal AF patients （r = 0.563, P 〈 0.05）, however, the relationship in persistent AF patients was poor （r = 0.094, P 〈 0.05）. Conclusions Both plasma hs-CRP and big ET-1 levels are elevated in lone AF patients, and are associated with AF. In paroxysmal lone AF patients, there were significant positive correlations between plasma hs-CRP level and big ET- 1 level.