系统性红斑狼疮患者C反应蛋白测定的临床意义  

Clinical significance of the detection of C-reactive protein in patients with systemic lupus erythematosus

作　　者：杨斌[1] 刘湘茹[1] 董维[1] 

机构地区：[1]广东省佛山市顺德第一人民医院血液风湿科,广东佛山528300

出　　处：《中国医药导报》2015年第11期117-120,128,共5页China Medical Herald

基　　金：广东省佛山市医学类科技攻关项目(编号2014AB002443)

摘　　要：目的探讨血清C反应蛋白（CRP）水平测定在系统性红斑狼疮（SLE）合并感染的患者诊治中的意义。方法选择2010年9月-2014年8月广东佛山市顺德第一人民医院风湿免疫科收治的196例SLE患者为研究对象,分别测定所有患者血清CRP水平和红细胞沉降率（ESR）,并按照SLE疾病活动指数评分标准（SLEDAI）进行疾病活动度评价,比较SLE合并和不合并感染患者血清CRP水平、ESR、SLEDAI,并比较不合并感染的SLE患者治疗前后上述指标。比较不合并感染的SLE患者不同疾病活动度时CRP、ESR;绘制CRP诊断SLE患者合并感染的ROC曲线,分析血清CRP测定对SLE患者合并感染的诊断价值。比较是否合并浆膜积液、肾脏损害、血液系统损害、神经系统损害、皮肤黏膜损害的SLE患者的血清CRP水平。结果 SLE合并感染患者血清CRP水平和ESR均高于不合并感染患者（均P〈0.05）,而SLEDAI在合并和不合并感染的SLE患者之间差异无统计学意义（P〉0.05）;不合并感染的SLE患者随着疾病活动度的增加血清CRP水平变化不大（P〉0.05）,而ESR呈增高趋势（P〈0.05）;合并感染的SLE患者免疫抑制剂治疗后CRP、ESR、SLEDAI均较治疗前显著降低,差异有统计学意义（均P〈0.05）;以CRP〉8.1 mg/L作为诊断截断点,CRP诊断SLE患者合并感染的敏感性和特异性分别为69.8%和83.6%;是否合并浆膜积液、肾脏损害、血液系统损害、神经系统损害、皮肤黏膜损害的SLE患者血清CRP水平差异均无统计学意义（P〉0.05）。结论 SLE患者血清CRP水平与疾病活动和器官受累无相关性,血清CRP水平升高可作为SLE患者合并感染的诊断指标,为临床抗感染治疗提供依据。Objective To investigate the clinical significance of C reactive protein（CRP） levels in the diagnosis of the patients with systemic lupus erythematosus（SLE） co-infection. Methods 196 patients with SLE admitted to rheumatism immunity branch of the First People＇s Hospital of Shunde from September 2010 to August 2014 were as the research objects, the level of serum CRP and erythrocyte sedimentation rate（ESR） of all the patients were determined respectively, and the SLE disease activity according to systemic lupus erythematosus disease activity index（SLEDAI） were evaluated, serum level of CRP, ESR, SLEDAI in SLE patients with co-infection or without were compared, and the indexes mentioned above in SLE patients with co-infection were compared. CRP, ESR in SLE patients in different infection degrees were compared; ROC curve of CRP in diagnosis of SLE patients was drew, the diagnostic value of serum CRP in SLE patients with co-infection was analyzed, serum CRP levels in SLE patients with or without kidney damage,blood system damage, nervous system damage, damage of skin mucous membrane were compared. Results Serum levels of CRP and ESR of SLE patients with co-infection on admission were higher than those of the patients without infection（all P〈0.05）, while there was no statistically significant differences in SLEDAI between the patients with co-infection or not（P〉0.05）; serum CRP level had little change with the disease activity increasing of SLE patients with infection（P〉0.05）, while ESR increased（P〈0.05）; CRP, ESR and SLEDAI of SLE patients with co-infection after immune inhibitor decreased significantly, the difference was statistically significant（all P〈0.05）; the sensitivity and specificity of CRP in diagnosis of SLE patients were 69.8% and 83.6% according to CRP 〉8.1 mg/L, the differences of serum CRP levels in SLE patients with merge serous effusion,kidney damage, blood system damage, nervous system damage, damage of skin mucous membrane or not were not statistic

关 键 词：系统性红斑狼疮 C反应蛋白 红细胞沉降率 感染 

分 类 号：R593.24[医药卫生—内科学]