Lawn S D, Obeng J, Acheampong J W, Griffin G E
Department of Infectious Diseases, St. George's Hospital Medical School, London, UK.
Int J Tuberc Lung Dis. 2000 Apr;4(4):340-4.
The Komfo Anokye Teaching Hospital, Kumasi, Ghana, West Africa.
To evaluate simple and commonly used parameters of the acute-phase response as correlates of successful resolution of smear-positive pulmonary tuberculosis (PTB) during drug treatment.
Serum C-reactive protein (CRP) concentration, erythrocyte sedimentation rate (ESR), body weight, and blood haemoglobin were measured in human immunodeficiency virus (HIV) negative Ghanaian patients with PTB (n = 15) and in age- and sex-matched healthy controls (n = 15). These parameters were subsequently measured in patients after 1, 2 and 3 months of antituberculosis treatment. Serum concentrations of soluble interleukin-2-receptor-alpha (sCD25) were also measured as a comparative index of resolution of the systemic inflammatory process.
Anti-tuberculosis treatment resulted in sputum smear conversion in all 15 patients. After one month of treatment, reductions in serum CRP concentration (>20%) and increases in haemoglobin concentration (>0.4 g/dl) occurred in the majority of patients and correlated with steep reductions in serum levels of sCD25. In contrast, weight loss and elevated ESR were slower to resolve, and were insensitive early markers of response to treatment.
A fall in serum CRP and a rise in blood haemoglobin are correlates of the initial response to drug treatment of PTB. These parameters may assist in the evaluation of empiric trials of treatment in microbiologically unconfirmed cases of suspected PTB.
西非加纳库马西的孔福·阿诺凯教学医院。
评估急性期反应的简单常用参数，作为药物治疗期间涂片阳性肺结核（PTB）成功治愈的相关指标。
对15例PTB的人类免疫缺陷病毒（HIV）阴性加纳患者和15例年龄及性别匹配的健康对照者测量血清C反应蛋白（CRP）浓度、红细胞沉降率（ESR）、体重和血红蛋白。随后在抗结核治疗1、2和3个月后对患者测量这些参数。还测量了可溶性白细胞介素-2受体α（sCD25）的血清浓度，作为全身炎症过程缓解的比较指标。
15例患者的抗结核治疗均使痰涂片转阴。治疗1个月后，大多数患者血清CRP浓度降低（>20%），血红蛋白浓度升高（>0.4 g/dl），且与血清sCD25水平急剧降低相关。相比之下，体重减轻和ESR升高缓解较慢，是治疗反应的不敏感早期指标。
血清CRP降低和血红蛋白升高是PTB药物治疗初始反应的相关指标。这些参数可能有助于评估疑似PTB微生物学未确诊病例的经验性治疗试验。
