Paul Rudrajit, Sinha Pradip K, Bhattacharya Raja, Banerjee Amit K, Raychaudhuri Pradip, Mondal Jayati
Department of Medicine, Medical College Kolkata, Kolkata, India.
Adv Biomed Res. 2012;1:41. doi: 10.4103/2277-9175.100140. Epub 2012 Aug 28.
C-reactive protein (CRP) is useful as marker of severity in malaria. African studies have shown that serum CRP levels correlate with parasite burden and complications in malaria, especially falciparum. However, there are very few data on CRP levels in Indian malaria patients.
We assessed CRP levels in malaria patients at presentation and studied for any relation of CRP levels with subsequent prognosis. Statistical tests included student's t-test, Mann Whitney U test, and chi square test, all with 2-tailed analyzes.
Of 71 patients in our study, 42 (59.1%) were infected with P. falciparum. 23 (32.4%) patients needed admission and 10 (14.1%) died. Average CRP levels were quite high in malaria patients (31.29 ± 20.4 mg/L). There was no significant difference in CRP between vivax and falciparum cases. Admitted patients had significantly higher CRP levels compared to those treated on outdoor basis (47.11 ± 19.13 vs. 23.71 ± 16.35 mg/L; P < 0.0001). 8 patients were admitted with multiple complications. They had significantly high CRP level compared to those with 1 complication (P = 0.015). Also, patients who died had higher CRP levels compared to survivors (P = 0.000346). CRP levels at presentation showed positive correlation with duration of hospital stay (r = 0.59; P < 0.05). CRP levels >35 mg/L was highly sensitive in predicting mortality.
Our study in Indian population corroborates the findings in African studies regarding prognostic role of CRP in malaria. CRP is an effective biomarker in assessing malaria severity and also for follow-up.
C反应蛋白（CRP）可作为疟疾严重程度的标志物。非洲的研究表明，血清CRP水平与疟疾尤其是恶性疟的寄生虫负荷及并发症相关。然而，关于印度疟疾患者CRP水平的数据非常少。
我们在疟疾患者就诊时评估其CRP水平，并研究CRP水平与后续预后的任何关系。统计检验包括学生t检验、曼-惠特尼U检验和卡方检验，均采用双侧分析。
在我们研究的71例患者中，42例（59.1%）感染恶性疟原虫。23例（32.4%）患者需要住院，10例（14.1%）死亡。疟疾患者的平均CRP水平相当高（31.29±20.4mg/L）。间日疟和恶性疟病例的CRP水平无显著差异。与门诊治疗的患者相比，住院患者的CRP水平显著更高（47.11±19.13 vs. 23.71±16.35mg/L；P<0.0001）。8例患者因多种并发症住院。与有1种并发症的患者相比，他们的CRP水平显著更高（P = 0.015）。此外，死亡患者的CRP水平高于幸存者（P = 0.000346）。就诊时的CRP水平与住院时间呈正相关（r = 0.59；P<0.05）。CRP水平>35mg/L对预测死亡率具有高度敏感性。
我们在印度人群中的研究证实了非洲研究中关于CRP在疟疾预后作用的发现。CRP是评估疟疾严重程度及进行随访的有效生物标志物。
