Dilber Embiya, Cakir Murat, Kalyoncu Mukaddes, Okten Ayşenur
Department of Pediatrics, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey.
Turk J Pediatr. 2003 Oct-Dec;45(4):311-4.
C-reactive protein (CRP) is one of the best indicators of the acute phase response to inflammation. The rapid kinetics of CRP metabolism appears to closely parallel the degree of inflammation. The purpose of this prospective study was to analyze the clinical value of CRP, erythrocyte sedimentation rate (ESR), and white blood cell count (WBC) in the assessment response to treatment in children with parapneumonic empyema. Thirty-eight children were prospectively studied. CRP was elevated in all patients on the day of hospital admission. With antibiotic treatment, serum CRP levels fell rapidly within the first days, and in 32 patients who had uncomplicated course, serial CRP levels fell progressively at each measurement. All but four patients had normal CRP levels on the day of hospital discharge. ESR was also elevated in all patients on the day of hospital admission. Despite antibiotic treatment, ESR continued to increase in all patients in the first few days, with peak values reached on day 3. Only three patients had normal ESR levels on the day of hospital discharge. In six patients who had a complicated course, after an initial decrease, CRP levels began to rise earlier than ESR and WBC count. Plasma CRP level is a sensitive marker not only in the diagnosis of parapneumonic empyema, but also in the management of treatment response.
C反应蛋白（CRP）是炎症急性期反应的最佳指标之一。CRP代谢的快速动力学似乎与炎症程度密切平行。这项前瞻性研究的目的是分析CRP、红细胞沉降率（ESR）和白细胞计数（WBC）在评估小儿肺炎旁胸腔积液治疗反应中的临床价值。对38名儿童进行了前瞻性研究。所有患者入院当天CRP均升高。经抗生素治疗后，血清CRP水平在最初几天内迅速下降，32例病程简单的患者每次测量时CRP水平均逐渐下降。除4例患者外，所有患者出院当天CRP水平均正常。所有患者入院当天ESR也升高。尽管进行了抗生素治疗，但所有患者的ESR在最初几天仍持续升高，在第3天达到峰值。只有3例患者出院当天ESR水平正常。在6例病程复杂的患者中，CRP水平在最初下降后，开始比ESR和白细胞计数更早升高。血浆CRP水平不仅是肺炎旁胸腔积液诊断的敏感标志物，也是治疗反应管理的敏感标志物。
