Shimetani N, Ichikawa K, Hachimura K, Tanaka T, Ohtani S, Kanoh Y, Ohtani H
Department of Clinical Pathology, Kitasato University School of Medicine, Sagamihara, Japan.
Rinsho Byori. 1996 Jul;44(7):669-75.
Both C-reactive protein (CRP) and Serum amyloid A protein(SAA) are determined as an indicator of inflammation and tissue damage. But serum CRP in the range less than 10 micrograms/dl was not correlated with SAA. We determined CRP, SAA and interleukin-6(IL-6) in sera of patients who had received corticosteroid therapy. CRP decreased extremely after administration of more than 50 mg/day corticosteroid. However, SAA and IL-6 levels changed independently from CRP levels. In the patients under long-term corticosteroid therapy, CRP decreased rapidly to the level below the reference range and remained low, while SAA decreased but to the level in the reference range, and IL-6 levels was unchanged. When they were complicated with infectious disease during the corticosteroid therapy, CRP increased to or above the reference level but not so markedly, however, SAA increased markedly and exceeded the upper reference range three or four days earlier than the day of CRP increase. It is suggested that serial SAA monitoring will be reliable for the early diagnosis of infection if the patients is taking corticosteroid therapy.
C反应蛋白（CRP）和血清淀粉样蛋白A（SAA）均被作为炎症和组织损伤的指标进行测定。但血清CRP水平低于10微克/分升时与SAA无相关性。我们测定了接受皮质类固醇治疗患者血清中的CRP、SAA和白细胞介素-6（IL-6）。每日服用超过50毫克皮质类固醇后，CRP急剧下降。然而，SAA和IL-6水平的变化与CRP水平无关。在长期接受皮质类固醇治疗的患者中，CRP迅速降至参考范围以下并维持在低水平，而SAA下降但仍在参考范围内，IL-6水平未改变。当他们在皮质类固醇治疗期间并发感染性疾病时，CRP升高至参考水平或以上，但升高不明显，然而，SAA明显升高，比CRP升高的日期提前三到四天超过参考范围上限。提示对于正在接受皮质类固醇治疗的患者，连续监测SAA对感染的早期诊断将是可靠的。
