Polyvalent Intensive Care Unit, Hospital de São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Estrada do Forte do Alto do Duque, Lisbon, Portugal.
Crit Care. 2011;15(3):R129. doi: 10.1186/cc10242. Epub 2011 May 19.
Several biomarkers have been studied in febrile neutropenia. Our aim was to assess C-reactive protein (CRP) concentration in septic critically ill cancer patients and to compare those with and without neutropenia.
A secondary analysis of a matched case-control study conducted at an oncologic medical-surgical intensive care unit (ICU) was performed, segregating patients with severe sepsis/septic shock. The impact of neutropenia on CRP concentrations at admission and during the first week of ICU stay was assessed.
A total of 154 critically ill septic cancer patients, 86 with neutropenia and 68 without, were included in the present study. At ICU admission, the CRP concentration of neutropenic patients was significantly higher than in non-neutropenic patients, 25.9 ± 11.2 mg/dL vs. 19.7 ± 11.4 mg/dL (P = 0.009). Among neutropenic patients, CRP concentrations at ICU admission were not influenced by the severity of neutropenia (< 100/mm3 vs. ≥ 100/mm3 neutrophils), 25.1 ± 11.6 mg/dL vs. 26.9 ± 10.9 mg/dL (P = 0.527). Time dependent analysis of CRP from Day 1 to Day 7 of antibiotic therapy showed an almost parallel decrease in both groups (P = 0.335), though CRP of neutropenic patients was, on average, always higher in comparison to that of non-neutropenic patients.
In septic critically ill cancer patients CRP concentrations are more elevated in those with neutropenia. However, the CRP course seems to be independent from the presence or absence of neutropenia.
已有多种生物标志物在发热性中性粒细胞减少症中进行了研究。我们的目的是评估脓毒症性危重症癌症患者的 C 反应蛋白（CRP）浓度，并比较伴有和不伴有中性粒细胞减少症的患者。
对肿瘤内科重症监护病房（ICU）进行的匹配病例对照研究进行了二次分析，将严重脓毒症/脓毒性休克患者进行了分类。评估了中性粒细胞减少症对 ICU 入院时和入住 ICU 第一周期间 CRP 浓度的影响。
本研究共纳入了 154 例患有严重脓毒症的癌症危重症患者，其中 86 例伴有中性粒细胞减少症，68 例不伴有中性粒细胞减少症。在 ICU 入院时，中性粒细胞减少症患者的 CRP 浓度明显高于非中性粒细胞减少症患者，分别为 25.9±11.2mg/dL 和 19.7±11.4mg/dL（P=0.009）。在中性粒细胞减少症患者中，CRP 浓度在 ICU 入院时不受中性粒细胞减少症严重程度的影响（<100/mm3 vs. ≥100/mm3 中性粒细胞），分别为 25.1±11.6mg/dL 和 26.9±10.9mg/dL（P=0.527）。抗生素治疗第 1 天至第 7 天 CRP 的时间依赖性分析显示，两组的 CRP 水平几乎呈平行下降（P=0.335），但中性粒细胞减少症患者的 CRP 水平平均始终高于非中性粒细胞减少症患者。
在患有脓毒症的危重症癌症患者中，中性粒细胞减少症患者的 CRP 浓度更高。然而，CRP 过程似乎与中性粒细胞减少症的存在与否无关。
