C反应蛋白及其复合指数在预测支气管炎急性恶化中的作用
Jun Zhang1, Sijiao Wang2, Minghui Wang3
1Department of Respiratory, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, 201700, China.
European journal of medical research
|August 26, 2025
概括
生物标志物如C反应蛋白 (CRP),CRP/白蛋白比率 (CAR) 和CRP/白前蛋白比率 (CPR) 可以预测支气管炎患者的频繁急性恶化. 单独测量CRP可能足以进行风险分层和指导干预.
科学领域:
- 肺部医学
- 生物标志物发现
- 炎症研究
背景情况:
- 支气管病变的急性恶化显著增加住院和死亡的风险.
- 确定可靠的生物标志物来预测恶化的频率至关重要,但仍未得到充分研究.
- C反应蛋白 (CRP) 和其衍生指数 (CAR,CPR) 反映了全身炎症和营养状况.
研究的目的:
- 评估CRP,CRP/白蛋白比率 (CAR) 和CRP/白蛋白前比率 (CPR) 在支气管切除患者急性恶化频率的预测能力.
- 确定这些炎症标志物是否可以识别患有频繁恶化风险较高的患者.
主要方法:
- 根据恶化频率分层的223名稳定的支气管切除症患者 (2009 - 2019) 的回顾性分析 (0, 1-2, ≥3次/年).
- 测量了血清CRP,白蛋白和前白蛋白水平;计算了CAR和CPR.
- 使用多变量逻辑回归和ROC曲线分析,对临床混因素进行调整.
主要成果:
- 较高的CRP,CAR和CPR水平与恶化频率的增加显著相关 (P< 0. 05).
- 在多变量调整后,CRP,CAR和CPR独立预测频繁恶化 (≥3/年) (aOR > 1,P < 0.01).
- 当被纳入临床模型时,CAR和CPR的预测准确度略高于单独CRP,但差异很小.
结论:
- 升高的CRP,CAR和CPR水平与支气管切除的恶化频率较高相关.
- 这些标志物可以独立预测患有频繁恶化的高风险的患者.
- 虽然CAR和CPR与CRP相比提供了极小的好处,但单独CRP可能足以对临床风险进行分层并指导早期干预.
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