Büyükşirin Melih, Anar Ceyda, Polat Gülru, Karadeniz Gülistan
Department of Chest Diseases, Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital, İzmir, Turkey.
Turk Thorac J. 2021 Jan;22(1):4-10. doi: 10.5152/TurkThoracJ.2020.19048. Epub 2021 Jan 1.
The purpose of this study was to determine the prognostic role of C-Reactive Protein (CRP) in acute PE.
Two hundred and twenty patients with acute PE were consecutively enrolled and followed for 30 days after discharge. Serum CRP and NT-proBNP were determined. Right ventricular function was evaluated by transthoracic echocardiography.
There was a significant difference in age, S-PESI, and CRP levels between the early mortality group and without early mortality group. There was statistically no significant difference between the groups with and without early mortality in terms of gender distribution and whether or not they received thrombolytic therapy for DVT. Pulmonary infarct, pleural fluid, or both have no effect on early mortality. There was no correlation between CRP and pro-BNP, right/left ventricular ratio. The serum CRP levels at diagnosis were significantly higher in patients with PE and with pleural effusion and pulmonary infarct than those in PE patients without pleural effusion and pulmonary infarct (4.75±4.91 ng/mL, 9.67±8.02 ng/mL; p<0.0003).
High levels of CRP owing to inflammation in pulmonary embolism associated with effusion and infarction reveals why early mortality is significant in this group. CRP may help in the risk stratification of patients with acute PE, especially those with effusion and pulmonary infarction. CRP is an inexpensive and easily applicable biochemical marker, which can be used to predict early mortality.
本研究旨在确定C反应蛋白（CRP）在急性肺栓塞（PE）中的预后作用。
连续纳入220例急性PE患者，并在出院后随访30天。测定血清CRP和N末端脑钠肽前体（NT-proBNP）。经胸超声心动图评估右心室功能。
早期死亡组与无早期死亡组在年龄、简化肺栓塞严重指数（S-PESI）和CRP水平上存在显著差异。在性别分布以及是否接受深静脉血栓形成（DVT）溶栓治疗方面，有早期死亡和无早期死亡的组间在统计学上无显著差异。肺梗死、胸腔积液或两者对早期死亡均无影响。CRP与脑钠肽前体、右/左心室比率之间无相关性。PE合并胸腔积液和肺梗死患者诊断时的血清CRP水平显著高于无胸腔积液和肺梗死的PE患者（4.75±4.91纳克/毫升，9.67±8.02纳克/毫升；p<0.0003）。
与积液和梗死相关的肺栓塞炎症导致的高CRP水平揭示了该组早期死亡率高的原因。CRP可能有助于急性PE患者的危险分层，尤其是那些有积液和肺梗死的患者。CRP是一种廉价且易于应用的生化标志物，可用于预测早期死亡率。
