Faculty of Clinical Medicine, Xuzhou Medical University, Xuzhou, China.
Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, 99 Huaihai West Road, Quanshan District, Xuzhou, Jiangsu Province, China.
Clin Exp Med. 2023 Dec;23(8):4483-4491. doi: 10.1007/s10238-023-01043-y. Epub 2023 Mar 28.
The aim of this study was to investigate the effect of C-reactive protein (CRP) on the prognosis of adult patients with Immune thrombocytopenia purpura (ITP). A retrospective study of 628 adult ITP patients, as well as 100 healthy and 100 infected patients, attending the Affiliated Hospital of Xuzhou Medical University from January 2017 to June 2022 was performed. The ITP patients were grouped according to their CRP levels, and the differences in clinical characteristics of each group and the influencing factors of efficacy in newly diagnosed ITP patients were analyzed. CRP levels were significantly higher in the ITP and infected groups compared with healthy controls (P < 0.001), and platelet counts were significantly lower in the ITP group (P < 0.001). Between the CRP normal and elevated group, their age, white blood cell count, neutrophil count, lymphocyte count, red blood cell count, hemoglobin, platelet count, complement C3 and C4, PAIgG, bleeding score, proportion of severe ITP, and proportion of refractory ITP were significantly different (P < 0.05). Patients of severe ITP (P < 0.001), refractory ITP (P = 0.002), and with active bleeding (P < 0.001) had significantly higher CRP levels. Patients with no response after treatment had significantly higher CRP levels than those who achieved CR or R (P < 0.001). Platelet counts (r = - 0.261, P < 0.001) in newly diagnosed ITP patients and treatment outcomes (r = - 0.221, P < 0.001) were negatively correlated with CRP levels, and bleeding score was positively correlated with CRP levels (r = 0.207, P < 0.001). Treatment outcome was positively correlated with decrease in CRP levels (r = 0.313, P = 0.027). A multifactorial regression analysis of the influencing factors of treatment outcomes on newly diagnosed patients found that CRP was an independent risk factor of the prognosis (P = 0.011). In conclusion, CRP can help assess the severity and predict the prognosis of ITP patients.
本研究旨在探讨 C 反应蛋白（CRP）对成人特发性血小板减少性紫癜（ITP）患者预后的影响。回顾性分析了 2017 年 1 月至 2022 年 6 月在徐州医科大学附属医院就诊的 628 例成人 ITP 患者，以及 100 例健康对照者和 100 例感染患者。根据 CRP 水平将 ITP 患者分为两组，分析各组的临床特征差异及初诊 ITP 患者疗效的影响因素。与健康对照组相比，ITP 组和感染组的 CRP 水平显著升高（P<0.001），血小板计数显著降低（P<0.001）。在 CRP 正常组和升高组之间，两组的年龄、白细胞计数、中性粒细胞计数、淋巴细胞计数、红细胞计数、血红蛋白、血小板计数、补体 C3 和 C4、PAIgG、出血评分、重型 ITP 比例、难治性 ITP 比例差异有统计学意义（P<0.05）。重型 ITP（P<0.001）、难治性 ITP（P=0.002）和有活动性出血的患者（P<0.001）的 CRP 水平显著升高。治疗后无反应的患者的 CRP 水平明显高于达到完全缓解（CR）或部分缓解（R）的患者（P<0.001）。初诊 ITP 患者的血小板计数（r=-0.261，P<0.001）和治疗结果（r=-0.221，P<0.001）与 CRP 水平呈负相关，出血评分与 CRP 水平呈正相关（r=0.207，P<0.001）。治疗结果与 CRP 水平的降低呈正相关（r=0.313，P=0.027）。对初诊患者的治疗结果影响因素的多因素回归分析发现，CRP 是预后的独立危险因素（P=0.011）。综上所述，CRP 有助于评估 ITP 患者的严重程度和预测预后。
