Thimsen D A, Tong G K, Gruenberg J C
Department of Surgery, Saginaw Cooperative Hospitals, Inc., MI 48602.
Am Surg. 1989 Jul;55(7):466-8.
C-reactive protein (CRP) was measured in 70 consecutive patients hospitalized with the diagnosis of acute appendicitis. Of these, 28 patients (Group 1) had acute appendicitis, 25 patients (Group 2) had no identifiable focus of infection and improved with general supportive care, and 17 patients (Group 3) had an identifiable cause for their illness, though not appendicitis. CRP level was not helpful in distinguishing among patients in any group when symptoms were present for 12 hours or less. When symptoms were present for more than 12 hours, all patients in Groups 1 and 3 and half of the patients in Group 2 had a significant increase in CRP value. Thus, a normal CRP value in a patient presenting with a duration of symptoms of more than 12 hours occurred only in Group 2; this difference was statistically significant (P less than 0.001). When symptoms are present for more than 12 hours, an increased CRP value supports the diagnosis of acute appendicitis and will identify patients who have signs and symptoms similar to acute appendicitis but who have another identifiable illness. When the CRP value is normal in a patient who has had symptoms for more than 12 hours, this patient does not have acute, appendicitis and can be followed in an outpatient setting.
对70例连续住院且诊断为急性阑尾炎的患者进行了C反应蛋白（CRP）检测。其中，28例患者（第1组）患有急性阑尾炎，25例患者（第2组）未发现感染病灶，经一般支持治疗后病情好转，17例患者（第3组）虽患有可明确病因的疾病，但并非阑尾炎。当症状出现12小时或更短时间时，CRP水平对区分任何一组患者均无帮助。当症状出现超过12小时时，第1组和第3组的所有患者以及第2组的一半患者CRP值显著升高。因此，症状持续时间超过12小时的患者中，仅第2组出现CRP值正常的情况；这种差异具有统计学意义（P小于0.001）。当症状出现超过12小时时，CRP值升高支持急性阑尾炎的诊断，并能识别出具有与急性阑尾炎相似的体征和症状但患有其他可明确疾病的患者。当症状持续超过12小时的患者CRP值正常时，该患者没有急性阑尾炎，可以在门诊随访。
