Liozon E, Venot J, Liozon F, Vidal E, Weinbreck P, Bordessoule D, Loustaud V
Service de Médecine Interne A, CHU, Limoges.
Ann Med Interne (Paris). 1990;141(4):319-24.
In a study of 25 giant cell arteritis patients, whose diagnoses were made by temporal artery biopsy, the authors compared the evolution of the erythrocyte sedimentation rate (ESR) with those of the acute phase proteins (APP): fibrinogen (F), C reactive protein (CRP), orosomucoid (O), haptoglobin (H) and alpha 2-globulins (alpha 2-G), before, during and after corticotherapy; 165 laboratory analyses were made. Prior to treatment, ESR was increased in 96% of the patients, O and H in 100%, F and CRP in 96% and alpha 2-G in 92%. CRP showed the greatest mean increase (21x). Statistically significant positive correlations were found between ESR and alpha 2-G, F, CRP and O. No significant relationship was observed between APP and the occurrence of ophthalmological complications or the length of treatment. The CRP level returned to normal within the first week of steroid therapy for 76% of the patients, before ESR, F and O. During the withdrawal phase of corticotherapy, an ESR greater than 30 mm almost always corresponded to an inflammatory syndrome and an ESR of less than 15 mm to its absence (kappa coefficient = 0.64, p less than 0.001); however, an ESR between 15 and 30 mm did not enable us to draw a conclusion as to the absence or presence of such a syndrome. After terminating steroid therapy, the relationship between ESR and an inflammatory syndrome was weaker (kappa coefficient = 0.57, p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)
在一项针对25例经颞动脉活检确诊的巨细胞动脉炎患者的研究中,作者比较了皮质激素治疗前、治疗期间及治疗后红细胞沉降率(ESR)与急性期蛋白(APP):纤维蛋白原(F)、C反应蛋白(CRP)、类黏蛋白(O)、触珠蛋白(H)和α2球蛋白(α2-G)的变化情况;共进行了165次实验室分析。治疗前,96%的患者ESR升高,100%的患者O和H升高,96%的患者F和CRP升高,92%的患者α2-G升高。CRP的平均升高幅度最大(21倍)。ESR与α2-G、F、CRP和O之间存在统计学上显著的正相关。未观察到APP与眼科并发症的发生或治疗时长之间存在显著关系。76%的患者在类固醇治疗的第一周内CRP水平恢复正常,早于ESR、F和O。在皮质激素治疗的撤药阶段,ESR大于30mm几乎总是对应炎症综合征,而ESR小于15mm则对应无炎症综合征(kappa系数=0.64,p<0.001);然而,ESR在15至30mm之间时,我们无法就此综合征的有无得出结论。终止类固醇治疗后,ESR与炎症综合征之间的关系变弱(kappa系数=0.57,p<0.02)。(摘要截选至250字)