Shimetani N, Ohba Y, Shimetani K, Mashiko T, Matsuyama N, Ohtani H, Morii M
Department of Clinical Pathology, Koshigaya Hospital Dokkyo University School of Medicine, Koshigaya 343-8555.
Rinsho Byori. 2001 Jan;49(1):56-60.
In patients with inflammatory conditions such as infection, cytokines induce the production of C-reactive protein(CRP) and serum amyloid A protein(SAA) in hepatic cells. It has been reported that upon viral infection, the serum SAA level increases by a greater degree than the serum CRP level. Procalcitonin (PCT), the precursor of calcitonin, is a new type of inflammatory marker that is specifically induced by bacterial infection, sepsis and lethal multiple organ failure, but not by viral infection, autoimmune diseases, tumors or surgical stress. To evaluate the immunoluminometric assay(LUMI test PCT; Brahms Diagnostics, Berlin, Germany) procedure for determining the PCT level and to study the clinical significance of the serum PCT level, we determined the serum levels of PCT, CRP and SAA in patients with various inflammatory diseases and normal subjects. The serum PCT level in the normal subjects was < 0.3 ng/ml. Among the patients with inflammatory disease who had a high CRP level(CRP > 20000 micrograms/dl), the PCT level was elevated only in those patients with severe bacterial infection. These results suggest that determining the PCT level may be useful in the differential diagnosis of severe bacterial infection. The patients who had a low CRP level(CRP < 150 micrograms/dl), had a PCT level within the normal range. The patients with autoimmune disease, viral infection, and fungal infection did not have an elevated PCT level.
在患有感染等炎症性疾病的患者中，细胞因子可诱导肝细胞产生C反应蛋白（CRP）和血清淀粉样蛋白A（SAA）。据报道，病毒感染时，血清SAA水平的升高幅度大于血清CRP水平。降钙素原（PCT）是降钙素的前体，是一种新型炎症标志物，由细菌感染、脓毒症和致死性多器官功能衰竭特异性诱导产生，而病毒感染、自身免疫性疾病、肿瘤或手术应激则不会诱导其产生。为评估用于测定PCT水平的免疫发光测定法（LUMI test PCT；德国柏林Brahms诊断公司）流程，并研究血清PCT水平的临床意义，我们测定了各种炎症性疾病患者和正常受试者的血清PCT、CRP和SAA水平。正常受试者的血清PCT水平<0.3 ng/ml。在CRP水平较高（CRP>20000微克/分升）的炎症性疾病患者中，仅严重细菌感染患者的PCT水平升高。这些结果表明，测定PCT水平可能有助于严重细菌感染的鉴别诊断。CRP水平较低（CRP<150微克/分升）的患者，其PCT水平在正常范围内。自身免疫性疾病、病毒感染和真菌感染患者的PCT水平未升高。
