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[C反应蛋白、白细胞计数及血沉在社区获得性肺炎严重程度评估中的应用]

[C-reactive protein, leukocyte count and ESR in the assessment of severity of community-acquired pneumonia].

作者信息

Bircan Ahmet, Kaya Ozlem, Gökirmak Münire, Oztürk Onder, Sahin Unal, Akkaya Ahmet

机构信息

Department of Chest Disease, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey.

出版信息

Tuberk Toraks. 2006;54(1):22-9.

Abstract

This study aimed to evaluate the relations between the levels of CRP, leukocyte count and ESR on admission and the severity of pneumonia according to the criteria of Turkish Thoracic Society (TTS) and British Thoracic Society (BTS) CAP guidelines. This study included the adult patients with CAP admitted to our clinic between the years 2003-2005. The history, physical findings, hemogram, ESR, the levels of CRP and the results of other laboratory investigations were obtained from the medical records. The patients were grouped according to BTS and TTS guidelines. The mean age was 47.2 years; 70 patients (75.3%) were male and 23 patients (24.7%) were female. The severity of pneumonia according to BTS criteria was correlated with the levels of CRP and leukocyte count (p= 0.037, p= 0.01, respectively). The severity of pneumonia according to TTS criteria was correlated with the levels of CRP, leukocyte count and ESR (p= 0.000, p= 0.014, p= 0.015, respectively). Among TTS pneumonia groups, there were statistically significant differences between groups 1 and 3; groups 1 and 4; groups 2 and 3 (p= 0.006, p= 0.041, p= 0.05, respectively) for mean CRP levels. The mean levels of CRP (103.2 +/- 76.4 mg/L), leukocyte count (19.8 +/- 9.5 x 10(3)/microL) and ESR (57.2 +/- 26.8 mm/hour) were statistically significantly higher in inpatients than the mean levels of CRP (53.2 +/- 52.8 mg/dL), leukocyte count (14.6 +/- 5.4 x 10(3)/microL) and ESR (43.1 +/- 25.9 mm/hour) in outpatients (p= 0.000, p= 0.001, p= 0.012, respectively) according to TTS. It is considered that CRP, a powerful marker of inflammation, is related with severity of pneumonia and a high level of CRP may be useful to make a decision about hospitalisation.

摘要

本研究旨在根据土耳其胸科学会(TTS)和英国胸科学会(BTS)社区获得性肺炎(CAP)指南的标准,评估入院时CRP、白细胞计数和血沉(ESR)水平与肺炎严重程度之间的关系。本研究纳入了2003年至2005年间入住我院门诊的成年CAP患者。从病历中获取病史、体格检查结果、血常规、ESR、CRP水平及其他实验室检查结果。根据BTS和TTS指南对患者进行分组。平均年龄为47.2岁;70例患者(75.3%)为男性,23例患者(24.7%)为女性。根据BTS标准,肺炎严重程度与CRP水平和白细胞计数相关(分别为p = 0.037,p = 0.01)。根据TTS标准,肺炎严重程度与CRP水平、白细胞计数和ESR相关(分别为p = 0.000,p = 0.014,p = 0.015)。在TTS肺炎组中,第1组和第3组、第1组和第4组、第2组和第3组之间的平均CRP水平存在统计学显著差异(分别为p = 0.006,p = 0.041,p = 0.05)。根据TTS,住院患者的CRP平均水平(103.2±76.4mg/L)、白细胞计数(19.8±9.5×10³/μL)和ESR(57.2±26.8mm/小时)在统计学上显著高于门诊患者的CRP平均水平(53.2±52.8mg/dL)、白细胞计数(14.6±5.4×10³/μL)和ESR(43.1±25.9mm/小时)(分别为p = 0.000,p = 0.001,p = 0.012)。炎症的有力标志物CRP被认为与肺炎严重程度相关,高水平的CRP可能有助于做出住院决策。

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