吉林医学
吉林醫學
길림의학
JILIN MEDICAL JOURANL
2015年
1期
36-38
,共3页
王旭亮%孙国磊%高书健%徐磊
王旭亮%孫國磊%高書健%徐磊
왕욱량%손국뢰%고서건%서뢰
C反应蛋白%重症社区获得性肺炎%价值
C反應蛋白%重癥社區穫得性肺炎%價值
C반응단백%중증사구획득성폐염%개치
C-reactive protein%Severe community-acquired pneumonia%Value
目的：探讨动态监测C-反应蛋白（ CRP，C-reactive protein）用于评估重症社区获得性肺炎疗效和预后的价值。方法：60例均为≥18岁的重症社区获得性肺炎患者，入住ICU的当天定义为D0，随后的每天定义为D1、D2、……D7。每天监测血CRP、降钙素原（ PCT）、白细胞（ WBC），计算SOFA评分。计算D1、D2、……D7的CRP值与D0的CRP值之比，定义为C-反应蛋白比率（ CRP-ratio），计算每日的C-反应蛋白值与前一天的C-反应蛋白值的变化值，称之为△CRP，用△CRP除以前一天的C-反应蛋白值，定义为C-反应蛋白变化率（ CRP-rate）。依据出院时结局，将患者分为存活组和死亡组，统计上述指标变化，在各组中对比分析，得出结论。结果：D3的CRP-ratio>0.55是疗效不佳，预后较差的一个标志（敏感性0.82；特异性0.54），与此点的PCT及SOFA评分相比具有更高的敏感性；CRP-rate≥0.25是治疗有效，预后良好的标志（敏感性0.81；特异性0.82）。结论：早期动态监测血CRP-rate能够评估重症社区获得性肺炎疗效和预后，计算CRP-ratio可以早在抗感染治疗后的第三天评估治疗效果和预后，较PCT及SOFA评分具有更高的敏感性。
目的：探討動態鑑測C-反應蛋白（ CRP，C-reactive protein）用于評估重癥社區穫得性肺炎療效和預後的價值。方法：60例均為≥18歲的重癥社區穫得性肺炎患者，入住ICU的噹天定義為D0，隨後的每天定義為D1、D2、……D7。每天鑑測血CRP、降鈣素原（ PCT）、白細胞（ WBC），計算SOFA評分。計算D1、D2、……D7的CRP值與D0的CRP值之比，定義為C-反應蛋白比率（ CRP-ratio），計算每日的C-反應蛋白值與前一天的C-反應蛋白值的變化值，稱之為△CRP，用△CRP除以前一天的C-反應蛋白值，定義為C-反應蛋白變化率（ CRP-rate）。依據齣院時結跼，將患者分為存活組和死亡組，統計上述指標變化，在各組中對比分析，得齣結論。結果：D3的CRP-ratio>0.55是療效不佳，預後較差的一箇標誌（敏感性0.82；特異性0.54），與此點的PCT及SOFA評分相比具有更高的敏感性；CRP-rate≥0.25是治療有效，預後良好的標誌（敏感性0.81；特異性0.82）。結論：早期動態鑑測血CRP-rate能夠評估重癥社區穫得性肺炎療效和預後，計算CRP-ratio可以早在抗感染治療後的第三天評估治療效果和預後，較PCT及SOFA評分具有更高的敏感性。
목적：탐토동태감측C-반응단백（ CRP，C-reactive protein）용우평고중증사구획득성폐염료효화예후적개치。방법：60례균위≥18세적중증사구획득성폐염환자，입주ICU적당천정의위D0，수후적매천정의위D1、D2、……D7。매천감측혈CRP、강개소원（ PCT）、백세포（ WBC），계산SOFA평분。계산D1、D2、……D7적CRP치여D0적CRP치지비，정의위C-반응단백비솔（ CRP-ratio），계산매일적C-반응단백치여전일천적C-반응단백치적변화치，칭지위△CRP，용△CRP제이전일천적C-반응단백치，정의위C-반응단백변화솔（ CRP-rate）。의거출원시결국，장환자분위존활조화사망조，통계상술지표변화，재각조중대비분석，득출결론。결과：D3적CRP-ratio>0.55시료효불가，예후교차적일개표지（민감성0.82；특이성0.54），여차점적PCT급SOFA평분상비구유경고적민감성；CRP-rate≥0.25시치료유효，예후량호적표지（민감성0.81；특이성0.82）。결론：조기동태감측혈CRP-rate능구평고중증사구획득성폐염료효화예후，계산CRP-ratio가이조재항감염치료후적제삼천평고치료효과화예후，교PCT급SOFA평분구유경고적민감성。
Objective To explore the value of dynamic monitoring C-reactive protein( CRP,C-reactive protein)that was used to as-sess the curative effect and prognosis of severe community-acquired pneumonia. Method 60 cases were more than 18 year old patients with severe community acquired pneumonia. The day of ICU admission was defined as D0,and the following days were successively defined as D1,D2,…,D7. Blood CRP value,procalcitonin(PCT)and white blood cells(WBC)were daily monitored,and sequence of organ failure score(SOFA)was daily calculated in each person. Calculation of D1,D2,…,D7 CRP value divided by D0 CRP value was defined as C-reactive protein ratio( CRP-ratio). The changes between the value of C-reactive protein of the daily and the day before were calculated, and were called △CRP. Calculation of △CRP divided by C-reactive protein values of the day before,was defined as C-reactive protein rate( CRP - rate). Basis in discharge end the patients were divided into survival group and death group,and the changes of above indexes were analyzed by statistics in each group,and the conclusion was obtained. Results CRP -ratio of D3> 0. 55 was a sign of poor curative effect and prognosis( sensitivity 0. 82;specificity 0. 82),which had higher sensitivity than PCT and SOFA score of D3. CRP - rate≥0. 25 was the mark of a effective treatment and a good prognosis( sensitivity 0. 81;specificity 0. 82 ). Conclusion Early dynamic monitoring of blood CRP-rate could be used to evaluate the curative effect and prognosis of severe community -acquired pneumonia,To calculate CRP-ratio could be as early in the third day after anti-infection treatment used to evaluate the treatment effect and prognosis,which had higher sensibility than the PCT and SOFA score.
