Casl M T, Rogina B, Glojnarić-Spasić I, Minigo H, Planinc-Peraica A, Jaksić B
Department of Clinical Chemistry, Clinical Hospital Merkur, Zagreb, Croatia.
Leuk Res. 1994 Sep;18(9):665-70. doi: 10.1016/0145-2126(94)90065-5.
We studied the behavior of four major acute phase proteins (SAA, CRP, ACT and AGP) in pyrexial occurrences of 16 neutropenic patients with acute leukemia. Altogether 37 febrile episodes were recorded; 27 were infectious in origin (microbiologically documented infection and clinically documented infection, MDI/CDI group) and 10 were pyrexias of unknown origin (PUO group). In the MDI/CDI group the mean value for the highest individual SAA concentration was 282 +/- 161 mg/l and in the PUO group 95 +/- 79 mg/l. The corresponding mean values were 4.0 mg/l (range 0.2-5.5 mg/l) in 10 control patients with 1 year remission and 0.8 mg/l (range < 0.1-1.2 mg/l) in 30 healthy adults. The peak value of SAA rose above 100 mg/l in 85% of our MDI/CDI pyrexias and in 40% of PUO. More reliable results were obtained when the difference between the value on the day when pyrexia occurred and the previous day was calculated. In that case, the difference was above 75 mg/l in 23 of 27 (85%) MDI/CDI pyrexias and in none of 10 (0%) PUO. In the MDI/CDI group the mean difference was 204 +/- 137 mg/l while it was only 26 +/- 19 mg/l in the PUO group. The statistical significance was very high (p < 0.0001). The CRP monitoring was very inferior to SAA while ACT and AGP monitorings were unsatisfactory.
我们研究了16例急性白血病中性粒细胞减少患者发热时四种主要急性期蛋白（血清淀粉样蛋白A、C反应蛋白、α1抗胰蛋白酶和α1酸性糖蛋白）的行为。共记录到37次发热发作；其中27次为感染性发热（微生物学确诊感染和临床确诊感染，MDI/CDI组），10次为不明原因发热（PUO组）。MDI/CDI组中个体血清淀粉样蛋白A最高浓度的平均值为282±161mg/L，PUO组为95±79mg/L。10例缓解1年的对照患者相应平均值为4.0mg/L（范围0.2 - 5.5mg/L），30名健康成年人的平均值为0.8mg/L（范围<0.1 - 1.2mg/L）。在我们的MDI/CDI组发热病例中，85%的血清淀粉样蛋白A峰值超过100mg/L，PUO组为40%。计算发热当天与前一天的值之差时，得到的结果更可靠。在这种情况下，27例MDI/CDI发热病例中有23例（85%）差值超过75mg/L，10例PUO病例中无一例（0%）差值超过75mg/L。MDI/CDI组平均差值为204±137mg/L，而PUO组仅为26±19mg/L。统计学显著性非常高（p<0.0001）。C反应蛋白监测远不如血清淀粉样蛋白A，而α1抗胰蛋白酶和α1酸性糖蛋白监测结果不理想。
