Unal Selma, Arslankoylu Ali Ertug, Kuyucu Necdet, Aslan Gönül, Erdogan Semra
Department of Pediatric Hematology, Faculty of Medicine, Mersin University Mersin, Turkey.
J Pediatr Hematol Oncol. 2012 Mar;34(2):85-9. doi: 10.1097/MPH.0b013e3182495573.
This study aimed at evaluating the value of C-reactive protein (CRP) and procalcitonin (PCT) levels in the differential diagnosis of fever in patients with sickle cell disease (SCD). The study included 86 children with SCD (group 1) and 49 controls (group 2). During the study, the patients had 114 acute episodes or routine visits to the units. They were classified as having vasoocclusive crisis with fever (group 1A), vasoocclusive crisis without fever (group 1B), and no crisis or fever (steady state, group 1C). Only patients with crises were admitted to the hospital. Patients admitted to the hospital with various clinical signs and symptoms each and every time were included in groups 1A, 1B, and 1C. Thus, a total of 114 clinical episodes were analyzed. The mean CRP levels in the 3 patient groups were significantly higher than that in the group 2, and among the patient groups, the mean CRP was significantly higher in group 1A than the other groups. The mean CRP level in group 1A and group 1B was significantly higher than that in group 1C. There were no significant differences among the 3 SCD groups in terms of the median serum PCT level; however, the median PCT level in group 1A, group 1B, and group 1C patients was significantly higher than that in group 2 patients. These data indicate that vasoocclusive disease with or without fever apparently does not significantly increase PCT levels in relation to the baseline status of children with SCD, which in turn are clearly more elevated than PCT levels of control children.
本研究旨在评估C反应蛋白（CRP）和降钙素原（PCT）水平在镰状细胞病（SCD）患者发热鉴别诊断中的价值。该研究纳入了86例SCD患儿（第1组）和49例对照者（第2组）。在研究期间，患者出现了114次急性发作或到各科室进行常规就诊。他们被分为伴有发热的血管闭塞性危象（第1A组）、不伴有发热的血管闭塞性危象（第1B组）以及无危象或发热（稳定状态，第1C组）。只有出现危象的患者才被收治入院。每次因各种临床体征和症状入院的患者被纳入第1A组、第1B组和第1C组。因此，共分析了114个临床发作情况。3个患者组的平均CRP水平显著高于第2组，且在患者组中，第1A组的平均CRP显著高于其他组。第1A组和第1B组的平均CRP水平显著高于第1C组。3个SCD组的血清PCT中位数水平无显著差异；然而，第1A组、第1B组和第1C组患者的PCT中位数水平显著高于第2组患者。这些数据表明，无论有无发热，血管闭塞性疾病相对于SCD患儿的基线状态而言，显然不会显著升高PCT水平，而SCD患儿的PCT水平又明显高于对照儿童的PCT水平。
