Wu J-F, Yang Y-H, Wang L-C, Lee J-H, Shen E-Y, Chiang B-L
Department of Pediatrics, National Taiwan University Hospital, Taipei.
Clin Exp Rheumatol. 2007 Sep-Oct;25(5):782-5.
To compare serial C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels in juvenile rheumatoid arthritis (JRA) patients and investigate their application as diagnostic parameters and prognostic predictive factors.
We carried out retrospective chart review among JRA patients who were followed-up at the National Taiwan University Hospital (NTUH) between 1994 and 2005.
Thirty-nine girls and 68 boys were included in this study. At the time of diagnosis, the prevalence of ESR was significantly greater than that of CRP (86.8% vs. 47.2%, p < 0.05). ESR revealed more responsiveness to treatment compared to CRP (SRMs were -0.69 and -0.31, respectively). At the time of diagnosis, high CRP levels (>or= 5mg/dL) correlated with poor therapeutic response, as do positive CRP (> 0.8 mg/dL) and high ESR levels (> 40 mm/h) after treatment for six months. Overall, initial high CRP levels (>or= 5mg/dL) demonstrated the strongest predictive role of failure of the first remission.
For disease diagnosis, ESR can be a better parameter than CRP but a high initial CRP level can strongly predict treatment failure of the first remission.
比较幼年类风湿关节炎（JRA）患者的连续C反应蛋白（CRP）和红细胞沉降率（ESR）水平，并探讨其作为诊断参数和预后预测因素的应用。
我们对1994年至2005年在台湾大学医院（NTUH）接受随访的JRA患者进行了回顾性病历审查。
本研究纳入了39名女孩和68名男孩。在诊断时，ESR的患病率显著高于CRP（86.8%对47.2%，p<0.05）。与CRP相比，ESR对治疗的反应性更高（标准化反应均值分别为-0.69和-0.31）。在诊断时，高CRP水平（≥5mg/dL）与治疗反应不佳相关，治疗6个月后CRP阳性（>0.8mg/dL）和高ESR水平（>40mm/h）也与治疗反应不佳相关。总体而言，初始高CRP水平（≥5mg/dL）对首次缓解失败的预测作用最强。
对于疾病诊断，ESR可能是比CRP更好的参数，但初始高CRP水平可强烈预测首次缓解的治疗失败。
