三种急性时相蛋白在急性上呼吸道感染诊治中的价值  

The Value of Three Acute Phase Proteins in Diagnosis and Treatment of Acute Upper Respiratory Infection

作　　者：林江[1] 温先勇[1] 梁军[1] 

机构地区：[1]泸州医学院附属医院检验科,四川省泸州市646000

出　　处：《医学理论与实践》2007年第11期1261-1263,共3页The Journal of Medical Theory and Practice

摘　　要：目的:探讨急性时相蛋白(APP)在上呼吸道感染诊断和治疗过程中的变化规律及应用价值。方法:采用速率散射比浊法对104例上呼吸道感染患者在诊断和治过程中C-反应蛋白(CRP)、血清淀粉样蛋白A(SAA)、α1-酸性糖蛋白(AAG)进行检测。结果:细菌感染患者三种急性时相蛋白浓度显著高于正常对照组(P<0.01),其中,以革兰阴性菌感染APP升高最为显著,革兰阳性菌次之,真菌感染升幅最低;病毒组APP中SAA较正常对照明显升高(P<0.01),其余二项无显著增高(P>0.05);细菌组与病毒组比较:CRP、AAG两项指标显著高于病毒组(P<0.05);SAA浓度均大幅升高,病毒组高于细菌组(P<0.05);两组患者治疗有效者APP(病毒组SAA)第3天已有下降,7d明显下降(P<0.01),至21d恢复至对照组水平(P>0.05),而预后不良的患者血中APP的浓度仍维持较高水平。结论:监测急性时相蛋白对上呼吸道感染的诊断、疗效观察和预后评估以及鉴别诊断均有较大价值。　Objective：To discuss the change and applicated significance of acute phase protein（APP） in diagnosis and treatment of acute upper respiratory infection.Methods：Acute phase proteins including C-reactive proteins（CRP）,serum amyloid A protein（SAA） and alphal-acid glycoprotein（AAG） of 104 patients with acute upper respiratory infection were detected by rate nephelometry during diagnosis and treatment.Results：Density of three APP were significantly higher in patients with bacterial infection than those in normal controls（P〈0.01）.Among the total,the level of APP in patients with infection of Gram-negative bacteria increased most significant,that of Gram-positive bacteria increased lower and Fungus bacteria was the lowest.The level of SAA in viral group were significantly higher than control group（P〈0.01）,the level of CRP and AAG had no significant increment（P〉0.05）.Contrast to viral group,the level of CRP and AAG in bacterial group increased more significant（P〈0.05）;Density of SAA in both group increased dramaticly,and it was more significant in viral group than bacterial group（P〈0.05）.APP（SAA of viral group）of responder in both group began to decrease three days after treatment,decreased significantly after a week（P〈0.01）,and roughly equaled with normal group after three weeks（P〉0.05）,but the density of APP in patients of prognosis mala was still on high level.Conclusion：Monitoring CRP levels is valuable in diagnosis of acute upper respiratory infection,observation of therapeutic effect,evaluation of prognosis,and antidiastole.

关 键 词：上呼吸道感染 急性时相蛋白 C-反应蛋白 淀粉样蛋白A Α1-酸性糖蛋白 

分 类 号：R446.62[医药卫生—诊断学]