C反应蛋白和红细胞沉降率在初治慢性肺曲霉病患者诊断及治疗反应监测中的作用

Role of C-Reactive Protein and Erythrocyte Sedimentation Rate in the Diagnosis and Monitoring of Treatment Response in Treatment Naïve Subjects with Chronic Pulmonary Aspergillosis.

作者信息

Sehgal Inderpaul Singh, Dhooria Sahajal, Rudramurthy Shivaprakash M, Prasad Kuruswamy Thurai, Muthu Valliappan, Aggarwal Ashutosh Nath, Garg Mandeep, Rastogi Pulkit, Agarwal Ritesh

机构信息

Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Sector-12, Chandigarh, 160012, India.

Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

出版信息

Mycopathologia. 2023 Oct;188(5):705-711. doi: 10.1007/s11046-023-00756-8. Epub 2023 Aug 7.

DOI:10.1007/s11046-023-00756-8

PMID:37550433

Abstract

PURPOSE

The role of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) for diagnosing chronic pulmonary aspergillosis (CPA) remains unknown. Herein, we investigate the diagnostic performance of serum ESR and CRP in CPA.

METHODS

We retrospectively analyzed the data of treatment-naïve subjects with CPA and diseased controls (post-tuberculosis lung disease on CT thorax). We treated CPA subjects with six months of oral itraconazole. Our primary objective was to evaluate the sensitivity and specificity of ESR and CRP in diagnosing CPA. The key secondary objective was to study the change in the inflammatory markers with treatment.

RESULTS

We included 434 subjects and 20 diseased controls. The sensitivity and specificity of ESR (n = 434) and CRP (at cut-off value of 10 mg/L, n = 308) in diagnosing CPA were 42.9% and 65%, and 52.3% and 65%, respectively. Both ESR and CRP had erratic trend following treatment. ESR and CRP declined or remained stable in approximately 60% of subjects but increased in approximately 40% of the subjects despite treatment.

CONCLUSION

Serum CRP and ESR have limited utility in diagnosing and following subjects with CPA.

摘要

目的

C反应蛋白（CRP）和红细胞沉降率（ESR）在诊断慢性肺曲霉病（CPA）中的作用尚不清楚。在此，我们研究血清ESR和CRP在CPA中的诊断效能。

方法

我们回顾性分析了未经治疗的CPA患者和疾病对照（胸部CT显示结核后肺部疾病）的数据。我们对CPA患者进行了为期6个月的口服伊曲康唑治疗。我们的主要目的是评估ESR和CRP在诊断CPA中的敏感性和特异性。关键的次要目的是研究治疗过程中炎症标志物的变化。

结果

我们纳入了434名受试者和20名疾病对照。ESR（n = 434）和CRP（临界值为10 mg/L，n = 308）在诊断CPA中的敏感性和特异性分别为42.9%和65%，以及52.3%和65%。治疗后ESR和CRP均呈不稳定趋势。尽管进行了治疗，但约60%的受试者ESR和CRP下降或保持稳定，而约40%的受试者ESR和CRP升高。