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为什么 C 反应蛋白是临床实验室最常要求检测的项目之一?

Why C-reactive protein is one of the most requested tests in clinical laboratories?

机构信息

Clinical Biochemistry and Clinical Molecular Biology, University of Padova, Padova, Italy.

Department of Pathology, University of Texas, Galveston, USA.

出版信息

Clin Chem Lab Med. 2023 Feb 6;61(9):1540-1545. doi: 10.1515/cclm-2023-0086. Print 2023 Aug 28.

Abstract

C-reactive protein (CRP) is an acute-phase protein which is synthesized by the liver in response to the secretion of several inflammatory cytokines including interleukin 6 (IL-6), IL-1 and tumor necrosis factor (TNF). CRP was the first acute-phase protein to be described and adopted in clinical laboratories as an exquisitely sensitive systemic marker of inflammation and tissue damage. The measurement of CRP is widely used for the diagnosis and monitoring of inflammatory conditions, including sepsis, trauma, and malignancies. In the last decades, impressive advances in analytical methods (from qualitative to high-sensitivity assays), automation and availability of results in a short time, not only translated in an increasing demand for the right management of systemic inflammatory diseases, but also in evaluating subclinical inflammatory processes underlying atherothrombotic events. CRP measurement is one of the most requested laboratory tests for both the wide range of clinical conditions in which it may assure a valuable information and some analytical advantages due to the evidence that it is a "robust biomarker". Even recently, the measurement of CRP received new interest, particularly as a biomarker of severity of Coronavirus disease 2019 (COVID-19), and it deserves further concern for improving demand appropriateness and result interpretation.

摘要

C-反应蛋白(CRP)是一种急性时相蛋白,由肝脏在几种炎症细胞因子(包括白细胞介素 6(IL-6)、IL-1 和肿瘤坏死因子(TNF))的分泌作用下合成。CRP 是第一个被描述并在临床实验室中被采用的急性时相蛋白,作为炎症和组织损伤的高度敏感的全身性标志物。CRP 的测量广泛用于炎症性疾病的诊断和监测,包括败血症、创伤和恶性肿瘤。在过去几十年中,分析方法(从定性到高灵敏度检测)、自动化和短时间内获得结果方面取得了令人瞩目的进展,这不仅导致对全身性炎症性疾病的正确管理的需求增加,而且还评估了动脉粥样硬化血栓事件潜在的亚临床炎症过程。CRP 测量是最受要求的实验室检测之一,因为它可以在广泛的临床情况下提供有价值的信息,并且由于证据表明它是一种“稳健的生物标志物”,因此具有一些分析优势。即使在最近,CRP 的测量也受到了新的关注,特别是作为 2019 年冠状病毒病(COVID-19)严重程度的生物标志物,并且值得进一步关注,以提高需求的适当性和结果的解释。

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