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目的探讨C-反应蛋白(CRP)在全身炎症反应综合征时的变化及与预后的关系。方法满足全身炎症反应(SIRS)诊断标准的住院病人60例为SIPS组,并按满足2项或3项、4项标准分为A1、A2亚组。根据是否由感染因素引发的SIRS,将60例SIPS患者分为B1亚组(sepsis 组)和B2亚组(非sepsis组)。按照CRP的高低将患者分为CRP轻度升高组(Ⅰ组,8-50 mg/L)、 CRP中度升高组(Ⅱ组,51-79mg/L)、CRP重度升高组(Ⅲ组,≥80 mg/L)。不满足SIRS诊断标准的急诊病人30例为非SIRS组。测定每位患者的CRP水平和APACHⅡ评分。结果 SIPS组CRP水平、APACHⅡ评分均高于非SIRS组。SIRS组CRP水平A2亚组高于A1亚组,B1亚组高于B2亚组。 CRP重度升高组(Ⅲ组)APACHⅡ评分和发生多器官功能障碍综合征(MODS)及病死率明显高于 CRP轻度升高组(Ⅰ组)、CRP中度升高组(Ⅱ组)。CRP中度升高组(Ⅱ组)APACHⅡ评分和发生 MODS及病死率明显高于CRP轻度升高组(Ⅰ组)。结论 CRP在SIRS病人明显升高。CRP测定对判断SIRS患者炎症反应轻重及预后有重要意义。
Objective To investigate the changes of C-reactive protein (CRP) in systemic inflammatory response syndrome and its relationship with prognosis. Methods A total of 60 inpatients who met the diagnostic criteria for systemic inflammatory response (SIRS) were selected as SIPS group and divided into A1 and A2 subgroups according to 2 or 3 criteria and 4 criteria. Sixty patients with SIPS were divided into B1 subgroup (sepsis group) and B2 subgroup (non-sepsis group) depending on whether SIRS was triggered by infection. According to the level of CRP, patients were divided into mild CRP increase group (group Ⅰ, 8-50 mg / L), moderate CRP group (group Ⅱ, 51-79 mg / L), severe CRP group Ⅲ Group, ≥80 mg / L). Thirty patients who did not meet the diagnostic criteria of SIRS were non-SIRS patients. CRP levels and APACH II scores were determined for each patient. Results The levels of CRP and APACHⅡ in SIPS group were significantly higher than those in non-SIRS group. The SIRS group CRP level A2 subgroup was higher than A1 subgroup, B1 subgroup was higher than B2 subgroup. The APACH Ⅱ score and the incidence of multiple organ dysfunction syndrome (MODS) and mortality in CRP severe group (group Ⅲ) were significantly higher than those in mild CRP group (group Ⅰ) and moderate CRP group (group Ⅱ). The APACH Ⅱ score and the incidence of MODS and mortality in moderate CRP group (group Ⅱ) were significantly higher than those in mild CRP group (group Ⅰ). Conclusion CRP in SIRS patients was significantly higher. CRP determination of SIRS patients to determine the severity of inflammation and prognosis of great significance.