Anush Meeval M, Ashok Vijay K, Sarma Ramakrishna In, Pillai Sreehari K
Kerala Institute of Medical Sciences Hospital, Trivandrum, Kerala, India.
Department of Internal Medicine, MES Medical College, Perinthalmanna, Kerala, India.
Indian J Crit Care Med. 2019 Jan;23(1):11-14. doi: 10.5005/jp-journals-10071-23105.
It has been observed that after any injury which is acute and also in the setting of inflammation or infection, the synthesis and secretion of C-reactive protein (CRP) rises within a few hours. The current study monitors CRP in patients presenting with sepsis and attempts to prove that it is one of the most reliable tests in determining the resolution and predicting the outcome.
During 12 months, 97 individuals with culture-proven sepsis were included, and a prospective observational study was done. Patients were assessed clinically by recording vitals, mean arterial pressure, Glasgow coma scale score, sequential organ failure assessment (SOFA) score as well as assessment of arterial blood gas and other blood investigations, which included CRP, total white cell count, differential count, serum creatinine, serum bilirubin on day 0, day 2 and day 5 after initiating antibiotics. To test the statistical significance of the difference in mean percentage changes of the different study variables between living and expired groups at day 2 and day 5, Wilcoxon's rank sum test was applied due to the non-normal distribution of values and small sample sizes.
The percentage drop of the mean of CRP from day 0 to day 2 was 23.33% in the living group, and there was an increase of 4.73 % in the expired group. The percentage drop of the mean of CRP on day 5 when compared to day 0, was significant in the living group.
C-reactive protein (CRP) is a more useful tool in predicting improvement and outcome in patients admitted with sepsis when compared to scoring systems like SOFA score.
AIMS: Amrita Institute of Medical Sciences, C1q: Complement 1q, CRP: C-reactive Protein, PCT: Procalcitonin, SOFA: Sequential organ failure assessment.
Anush MM, Ashok VK, Sarma RIN, Pillai SK. Role of C-reactive Protein as an Indicator for Determining the Outcome of Sepsis. Indian Journal of Critical Care Medicine, January 2019; 23(1):11-14.
据观察,在任何急性损伤以及炎症或感染情况下,C反应蛋白(CRP)的合成与分泌会在数小时内升高。本研究监测脓毒症患者的CRP,并试图证明它是判断病情好转及预测预后最可靠的检测指标之一。
在12个月期间,纳入了97例经培养证实为脓毒症的患者,并进行了一项前瞻性观察研究。通过记录生命体征、平均动脉压、格拉斯哥昏迷量表评分、序贯器官衰竭评估(SOFA)评分以及评估动脉血气和其他血液检查项目,包括抗生素治疗开始后第0天、第2天和第5天的CRP、白细胞总数、分类计数、血清肌酐、血清胆红素,对患者进行临床评估。由于数值分布不呈正态且样本量较小,为检验存活组和死亡组在第2天和第5天不同研究变量平均百分比变化差异的统计学显著性,应用了Wilcoxon秩和检验。
存活组CRP均值从第0天到第2天下降了23.33%,而死亡组上升了4.73%。与第0天相比,存活组第5天CRP均值的下降百分比具有显著性。
与SOFA评分等评分系统相比,C反应蛋白(CRP)在预测脓毒症患者的病情改善和预后方面是更有用的工具。
AIMS:阿姆里塔医学科学研究所,C1q:补体1q,CRP:C反应蛋白,PCT:降钙素原,SOFA:序贯器官衰竭评估。
Anush MM, Ashok VK, Sarma RIN, Pillai SK. C反应蛋白作为判断脓毒症预后指标的作用。《印度重症监护医学杂志》,2019年1月;23(1):11 - 14。