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Antecedentes. Son múltiples los recursos utilizados en el manejo de niñosquemados,debido a la respuesta inflamatoria secundaria a quemadurases necesario determinar la ausencia o presencia de infecciones asociadas, ya que constituyen la principal causa de muerte en pacientes quemados pediátricos. El uso de la procalcitonina y proteína C reactivasirven de apoyo en el seguimiento y diagnóstico de infecciones. Objetivo. Determinarla utilidad de procalcitonina y proteína C reactivacomo reactantes agudos en niños quemados. Métodos. Se revisaron 74 pacientes pediátricos quemados en el hospital Dr. Francisco de Icaza Bustamante, del año 2015. Fue undiseño no experimental, de tipo descriptivo, de corte trasversal. Resultados.Los niños atendidos por quemaduras fueron masculinos con 56,75% y femenino del 43,25%. Con mayor frecuencia estuvieron los pacientes entre 0-3 años de edad con 56,75%; y de este el masculino tuvo el 33,78% comparado con el femenino del 22,97%, la mayoría de quemaduras fue secundaria a líquidos calientes (68,92%). La afectación de superficie corporal quemada estuvo entre 10 a <20% (64,86%) y fueron del grado II de profundidad (66,21%). El índice de gravedad tuvo un 51,35% como grave. Conclusiones.Las pruebas de PCR y PCT como reactantes de fase aguda no mostraron un valor significativo de utilidad que pudiera relacionar u orientar dicho resultado con el Índice de Gravedad, evidenciando que en este grupo de pacientes no influyó en el manejo terapéutico en las diferentes fases descritas.
Background.There are multiple resources used in the management of burned children; due to the inflammatory response secondary to burns, it is necessary to determine the absence or presence of associated infections, since they are the main cause of death in burned pediatric patients. The use of procalcitonin and C-reactive protein, support the follow-up and diagnosis of infections. Objective.To determine the utility of procalcitonin and C reactive protein as acute reactants in burned children. Methods.We reviewed 74pediatric patients burned at the hospital Dr. Francisco de Icaza Bustamante, January 1-December 31, 2015. It was a non-experimental, descriptive, cross-cut design. Result.The children treated for burns were male with 56.75% and female with 43,25%. Morefrequent were patients between 0-3 years of age with 56,75%; and of this the masculine had 33,78%compared to the feminine of 22,97%, the majority of burns was secondary to hot liquids (68,92%). The affectation of burned corporal surface was between 10 to <20% (64,86%) and theywere of degree II of depth (66,21%). The severity index had 51,35% as serious.Conclusions. PCR and PCT tests as acute phase reactants did not show a significant value of utility that could relate or guide the result with the Severity Index, evidencing that in this group of patients it did not influence the therapeutic management in the different phases described.
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Child, Preschool , Therapeutics , Risk , Hormones , HospitalizationABSTRACT
Objective To examine serum levels of complement component 3(C3), complement component 4(C4), high sensitivity C reactive protein (hs-CRP), and uric acid (UA) in schizophrenia (SZ) patients and study their clinical significance. Methods One hundred forty-four SZ patients were recruited as SZ group. According to use of antipsychotics within four weeks, patients were divided into drug group (77 cases) and non-drug group (67 cases). One hundred forty-seven healthy subjects from health checkup center in the second XiangYa hospital during the same period were selected as control group. The concentrations of serum C3, C4, hs-CRP, and UA from SZ patients and healthy subjects were measured using immuno-scatter turbidmetry, latex-enhanced immunoturbidimetric assay, urea oxidase method, respectively. Results The serum levels of complement C3 and C4 were lower in SZ patients than in control group [(0.99±0.17) g/L vs. (1.03±0.17) g/L、(0.21±0.05) g/L vs. (0.23±0.05) g/L], and the serum levels of UA in serum of was higher in SZ patients than in control group [(351.61±95.90) μmol/L vs. (300.28±39.57) ?mol/L]. The differences had statistical significance (P<0.05, P<0.05, and P<0.001, respectively). The serum levels of C3, C4, hs-CRP, and UA were higher in drug group than in no-drug group [(1.04±0.19) g/L vs. (0.95±0.15) g/L、(0.22±0.06) g/L vs. (0.20±0.05) g/L、1.08(0.33, 5.04) mg/L vs. 0.47(0.28, 1.29) mg/L、(374.54±108.33)μmol/L vs. (331.61±79.03)μmol/L], and the differences had statistical significance (P<0.01).The concentrations of serum hs-CRP and UA were higher in drug group than in control group[1.08(0.33, 5.04) mg/L vs. 0.61(0.33, 1.26) mg/L、(374.54±108.33) μmol/L vs. (300.28±39.57) μmol/L], and differences had statistical significance (P<0.001). Conclusion The serum levels of C3, C4, hs-CRP, and UA in SZ Patients will be of guiding significance for clinical diagnosis of SZ and efficacy evaluation of antipsychotic drugs.
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Objective To study the association of carotid atherosclerosis with high-sensitivity creative protein(hs-CRP),lipoprotein-a(Lp-a) and superoxide dismutase(SOD) in patients with chronic renal failure (CRF).Methods Seventy-one CRF patients were divided into Group A of 45 patients under maintenance hemodialysis and Group B of 26 patients without hemodialysis,and 20 healthy donor was Group C in this study.And 71 CRF patients were divided into carotid atherosclerosis group (43 cases) and non carotid atherpsclerosis group(28 cases) according to whether the carotid atherosclerosis plaque was detected out.Fortythree CRF patients presented carotid atherosclerosis including 17 patients with soft plaque,10 patients with hard plaque and the other 16 with mixed plaque.Color ultra-sound was used to measure the carotid intimal medial thickness(IMT) and define the type of plaque.Levels of hs-CRP,Lp (a) and SOD were detected and analyzed in this study.Results (1) Levels of hs-CRP,Lp-a,SOD and IMT were significantly different in group A ((7.39±2.25) ag/L,(428.43±102.25) mmol/L,(71.35±21.52) KU/L and (1.23±0.31) mm,respectively),group B((7.41±1.67) mg/L,(432.12±96.43) mmol/L,(68.14±15.25) KU/L and (1.18±0.26) mm,respectively),and group C ((2.11 ± 0.86) mg/L,(193.32 ± 62.31) mmol/L,(94.23 ± 21.13)KU/L and (0.61 ±0.22) mm,respectively),the differences were significant (F =2.998,2.783,2.032,2.802;P＜0.05).Plaque incidence was increased in group A(68.9％) and group B(69.2％) compared with group C (12.5％) with statistical significance (x2=17.863,17.989;P＜0.001).(2) Furthermore,for CRF patients,hsCRP and Lp-a were positively related to IMT in group A (r =O.436,0.279;P＜0.05) and group B (r =0.652,0322;P ＜ 0.05),SOD presenting negative relationship with IMT (r =-0.283,P ＜ 0.01 for group A,and r =-0.164,P＜0.05 for group B).(3) Level of hs-CRP and Lp-a in carotid atherosclerosis group were higher than those in non carotid atherosclerosis group((7.58±2.47) mg/L vs.(3.41±1.26) mg/L,(437.31±115.38) mmol/L vs.(256.24± 101.22) mmol/L),the differences were significant (t =2.917,2.583;P ＜0.05).Level of SOD in carotid atherosclerosis group was lower than that in non carotid atherosclerosis group ((68.43±13.36) KU/L vs.(76.22±17.12) KU/L),the difference was signifiant(t=2.156,P＜0.05).(4)Level of hs-CRP and SOD in patients with soft plaque and mixed plaque were statistically different from those in patients with hard plaque(F=4.210,2.056;P＜0.05).Conclusion The micro-inflammatory status,oxidative stress and disturbance of Lp-a metabolism are extensively existed in CRF patients and closely connect to each other.Therefore,they might correlate with the formation of plaques in carotidartery.
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Objective To investigate characteristics of free fatty acid (FFA) and high-sensitivity Creactive protein (hs-CRP) in patients with type 2 diabetes mellitus and metabolic syndrome (MS) compared to those with type 2 diabetes mellitus without MS.Methods Totally 120 patients with type 2 diabetes mellitus who received blood glucose control in Shaoxing People's Hospital from January to June 2013 were recruited and divided into MS group (n =56) and non-MS group (n =64).The serum FFA profile of the patients was measured by enzymatic assay, and the serum hs-CRP level measured by particle-enhanced immuno-precipitation assay.Results The level of FFA was higher in the MS group than that in the non-MS group [(0.60 ±0.25) mmoL/L vs.(0.45 ±0.21) mmol/L, P =0.033].The level of hs-CRP was higher in the MS group than that in the non-MS group [5.29 (4.69-5.82) mg/L vs.0.73 (0.42-1.26) mg/L, P =0.000].The level of hs-CRP was higher in the patients with central obesity than that in those without central obesity [4.34 (0.91-5.46) mg/L vs.1.80 (0.82-3.27) mg/L, P=0.014], also higher in hypertensive patients than in non-hypertensive patients [5.21 (3.18-5.96) mg/L vs.2.93 (0.89-4.98) mg/L, P =0.012].Conclusions Serum FFA and hs-CRP concentrations may be significantly higher in type 2 diabetes mellitus patients with MS.The increased levels of FFA and hs-CRP may play an important role in the pathogenesis of type 2 diabetes mellitus and MS.
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Objective To explore the relationship between the levels of inflammatory factors and carotid intima-media thickness (IMT) in patients with type 2 diabetes mellitus (T2DM).Methods Fifty patients with T2DM were recruited and divided into T2DM with insulin resistance(IR) group(26 patients) and T2DM without insulin resistance (NIR) group (24 patients) according to insulin resistance index (HOMA-IR).Twenty-four healthy individuals conducting physical examination were recruited as the healthy control group.All participants underwent carotid ultrasound IMT to assess carotid intima-media thickness.The level of fasting plasma glucose (FPG),fasting insulin (FINS),blood lipids,high sensitivity C reactive protein (hs-CRP) and tumor necrosis factor-α(TNF-α) were measured.Homeostasis model assessment (HOMA)index was used for quantitative analysis of HOMA-IR.Results The levels of HOMA-IR,hs-CRP,TNF-α and IMT in control group,NIR group and IR group increased gradually and were significantly different(HOMA-IR:(1.74 ±0.49) vs.(2.24 ±0.41) vs.(4.89 ±0.84) ;F =190.228,P ＜0.01) ;hs-CRP(mg/L):(1.75 ±0.83) vs.(3.08 ± 1.04) vs.(5.89 ± 1.17) ;F =106.523,P ＜ 0.01) ;TNF-α (ng/L):(15.25 ± 7.64) vs.(23.38 ± 8.82) vs.(47.42 ± 9.97) ;F =89.210,P＜0.01) ;IMT(mm):(0.69 ±0.31) vs.(1.07±0.32) vs.(1.49±0.43);F=30.942,P＜0.01).Correlation analysis showed that the level of hs-CRP was positively correlated with the levels of HOMA-IR and IMT (r =0.453 and 0.395 respectively,P ＜ 0.05) ;The level of TNF-α was positively correlated with the levels of HOMA-IR and IMT (r =0.428 and 0.376 respectively,P ＜ 0.05) ; The level of HOMA-IR was positively correlated with the level of IMT (r =0.403,P ＜ 0.05).Conclusion Inflammatory activity is found in patients with T2DM,which is significantly correlated with insulin resistance.Inflammatory factors and insulin resistance play an important role in the occurrence and development of carotid atherosclerosis in patients with T2DM.
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Objective To analyze the efficacy of rosuvastatin on the patients with hyperlipidemia and hypertension.Methods From March 2011 to June 2012,112 cases with hyperlipidemia and hypertension in our hospital were enrolled in this study.Patients were randomly divided into treatment group and control group (56 patients,each).Patients in control group were treated with oral amlodipine 5 mg/d.Patients in treatment group were treated with oral rosuvastain 10 mg/d and oral amlodipine 5 mg/d.One month after the treatment,the levels of blood pressure,total cholesterol (TC),tryglyceride (TG),low density liporotein (LDL-C),high density lipoprotein cholesterol (HDL-C),high sensitivity C-reactive protein (hsCRP) were determined.The occurrence of adverse effects were observed.Results One month after treatment,systolic blood pressure and diastolic blood pressure were significantly decreased in both two groups compared with pre-treatment [Control group:(135.2±9.51)mm Hgvs.(59.2±7.3)mm Hg,(88.8±5.2)mm Hg vs.(99.5±8.3)mm Hg,t=4.95,2.87; Treatment group:(130.2±5.5)mm Hg vs.(160.3±9.3)mm Hg,(86.7± 10.2)mm Hg vs.(99.7±8.3)mm Hg,t=5.03,2.94,all P＜0.01],but more declines were found in treatment group than in control group(t=3.96,3.42,both P＜0.001).The levels of LDL-C,TG and TC were significantly decreased in both two groups compared with pre-treatment [Control group:(2.64±0.72)mmol/L vs.(3.97±0.84)mmol/L,(1.89±0.25)mmol/L vs.(2.56±0.45)mmol/L,(4.23±0.56)mmol/L vs.(7.36±0.48)mmol/L,t=2.58,3.03,2.36,P=0.013,0.004,0.022;Treatment group:(1.75 ± 0.68) mmol/L vs.(3.85 ± 0.79) mmol/L,(1.71 ± 0.18) mmol/L vs.(2.63±0.42)mmol/L,(3.18±0.47)mmol/L vs.(7.20±0.56)mmol/L,t=2.77,3.16,2.59,P=0.008,0.003,0.012,respectively],but more declines were observed in treatment group than in control group(t=6.73,4.37,10.70 respectively,all P＜0.05).The HDL-C concentrations were increased in both two groups compared with pre-treatment [Control group:(0.97±0.26)mmol/L vs.(0.75±0.31)mmol/L,t=2.89,P=0.006; Treatment group:(1.09±0.23)mmol/L vs.(0.72±0.24)mmol/L,t=3.01,P=0.004],but more increment were observed in treatment group than in control group(t=2.59,P＜0.05).The hsCRP concentration was significantly reduced in treatment group compared with pre-treatment [(1.32±0.17) mg/L vs.(4.97±0.13) mg/L,t=4.40,P＜0.001].There were no significant differences in liver and kidney function between the two groups.Serious adverse effects were not found.Conclusions Rosuvastatin combined with routine antihypertensive therapy can effectively decrease the levels of serum LDL-C,TG,hsCRP; increase serum HDL-C concentration and blood pressure can be effectively controlled.
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ObjectiveTo investigate the hypersensitive C-reactive protein(hs-CRP),level in serum and the heart rate variability(HRV) in patients with dysthymic disorder,and explore the possible psychological and physiological mechanisms.MethodsPHI and short-term HRV were measured in 42 patients with dysthymic disorder( DD group),33 patients with major depressive disorder ( MD group)and 30 heathy controls( NC group),fasting blood samples were also analyzed with high-sensitivity C-reactive protein (hs-CRP).Results ( 1 ) DD group gained higher score in the somatization,anxiety,psychopathic deviate and hypomania than the MD group(P＜0.05 or P ＜ 0.01 ).(2)The standard deviation of differences between the consecutive RR intervals (SDNN),the percentage value of consecutive RR intervals that differ more than 50 ms(PNN50) and the high frequency band(HF) of DD group were lower significantly than MD and NC groups,the low frequency band(LF),and the ratio of LF to HF power(LF/HF) and hs-CRP level were higher than other two groups (P ＜ 0.05 or P＜0.01 ).(3)The somatization and anxiety were correlated with SDNN,the very low frequency band(VLF),LF and hs-CRP level ( r=-0.27,-0.29,r=0.38,0.33,r=0.41,0.31,r=0.34,0.23,P＜0.05 or P＜0.01).(4)The hs-CRP level in serum were correlated with SDNN,the root mean square of successive RR intervals (RMSSD),the standard deviation of differences between the consecutive RR intervals ( SDSD),VLF,LF,HF and LF/HF ( r =- 0.47,- 0.45,- 0.45,0.26,0.46,-0.51,0.10,P ＜ 0.05 or P ＜ 0.01 ).ConclusionThe patients with dysthymic disorder have significant somatization and anxiety,the personality character was mainly resulting in reducing HRV,which is related with the increasing serum hs-CRP level.
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Objective To discuss the value of Visfatin in severity evaluation in patients with severe pneumonia via observation on the variations of the plasma level of Visfatin. Method Seventy subjects including 40 patients with severe pneumonia ( group A) and 30 patients with non-severe pneumonia (group B) admitted to the ICU of emergency department and general wards from June 2009 to June 2010, were enrolled in this prospective study, and another 30 healthy individuals from physical examinees were included as subjects in control group (group C). Patients with severe diseases of heart, brain and kidney, cancers, autoimmune disease, or under special treatment in latest one month were excluded. For the subjects of all three groups, the plasma levels of Visfatin, IL-6, IL-8 and TNF-α were measured by using ELISA, while the level of CRP was assayed by using immunoturbidimetry, and the routine blood test was performed as well. The blood gas analysis and Acute Physiology and Chronic Health Evaluation Ⅱ ( APACHE Ⅱ) were carried out in patients with pneumonia. Comparisons between groups were made by t-tests, ANOVA or nonparametric test. Correlation analysis was carried out by Pearson correlation coefficient or Spearman rank correlation test. Results The plasma level of Visfatin in patients with severe pneumonia (group A) was significantly higher than that in patients with non-severe pneumonia (group B) and in the control subjects (group C) (P < 0. 01) , and the level of Visfatin in pneumonia ( group B) and in control group (group C) , and that in group B was significantly higher than that in the controls (group C) (P <0. 01). In group A, the plasma level of Visfatin was positively correlated with CRP, TNF-α, APACHE Ⅱ and PMN% (rha =0. 653, r = 0.554, r = 0.558, r= 0.484, P <0. 05), while negatively correlated with PaO2 and PaO2/FiO2 ( rha = -0.422, r= -0.543, P <0. 05). Conclusions Visfatin may be involved in the systemic inflammation response in severe pneumonia as a pro-inflammatory cytokine which is valuable in assessing the severity of pneumonia.
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The identification of the specific cause in every patient has important clinical implications, because ischemic stroke is an etiologically heterogeneous disease. The Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification can be used to define the etiology of stroke. However, TOAST classification can not be completed timely on admission of patients with acute stroke, which has impacted early guidance of clinical treatment. This article reviews the biological markers of early differential-diagnostic significance of the TOAST classification.
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Justificativa e objetivos: Vários estudos mostram o valor da proteína C-reativa (PCR) na avaliação de pacientes com doença cardiovascular prévia ou fatores de risco, porém, não há um consenso das sociedades científicas quanto à aplicação deste marcador para avaliação destes pacientes no evento agudo. O objetivo deste estudo foi avaliar os níveis de PCR e perfil lipídico em pacientes na fase aguda de infarto agudo do miocárdio (IAM). Método: Foram avaliados 36 pacientes atendidos em emergência cardiológica entre maio e junho de 2007. Foram dosadas PCR de alta sensibilidade (PCR-as) por método imunoturbidimétrico e perfil lipídico. Resultados: Amostra composta de 83,4% de pacientes do sexo masculino e idade média de 62 anos. Aproximadamente 75% dos pacientes eram portadores de hipertensão arterial sistêmica (HAS), 66,6% tabagistas, 33,3% com história prévia de doença coronariana (DAC) e 30,5% portadores de diabetes mellitus (DM). O IAM sem elevação do segmento ST (IAMSEST) representou 58,3% dos casos. Foram registrados 72,2% pacientes com valores de PCR-as > 3 mg/L. O IAMSEST esteve associado com maiores níveis de PCR-as em relação ao IAM com elevação do segmento ST. Tabagistas e pacientes com DAC prévia tiveram maiores médias de PCR-as, não sendo observada relação estatística entre HAS ou DM com este marcador inflamatório. Os níveis de PCR-as foram maiores nos grupos com colesterol total e LDL-colesterol aumentados. Conclusão: Estes resultados indicam que os pacientes apresentam altos valores da PCR-as na fase aguda do IAM. Observou-se que o IAMSEST, história de tabagismo ou DAC prévia, colesterol total e LDL-colesterol aumentados relacionam-se com valores maiores da PCR-as, tendo estes grupos maior status inflamatório.
Background and objectives: Many studies show the value of C-reactive protein (CRP) in assessment of patients with previous cardiovascular disease or risk factors, but, there is no agreement of scientific societies about the use of this marker to assess these patients on acute event. The objective of this study was assessing CRP levels and lipid profile in patients with acute myocardial infarction (AMI). Method: Have been appraised 36 patients attended on cardiologic emergency among May and June of 2007. We accessed clinical profile, dosages of high sensitivity CRP (hs- CRP) by imunoturbidimetric method and profile lipid. Results: Pattern was built up from 83.4% of patients of male gender and median-age about 62 years. Approximately 75% patients had arterial hypertension (SAH), 66.6% smokers, 33.3% with previous history of coronary disease (CAD) and 30.5% had diabetes mellitus (DM). Non-STsegment elevation AMI (NSTSEAMI) was 58.3% of the cases. Have been registered 72.2% patients with hs-CPR levels higher than 3mg/L. NSTSEAMI was associate with higher levels of hs-CPR when compared with AMI with ST-segment elevation. Smokers and previous CAD patients had higher median of hs-CPR levels, no being observed statistics relation between SAH and DM with this inflammatory marker. The hs-CRP levels were higher in groups of higher levels of total cholesterol and LDL-cholesterol. Conclusion: These results indicate that patient present elevated hs-CPR levels in AMI. Also, NSTSEAMI, smokers, previous CAD, high levels of total cholesterol and LDL-cholesterol are related to higher hs-CRP levels, being these groups under major inflammatory status.
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Humans , Male , Female , Aged , C-Reactive Protein , Myocardial InfarctionABSTRACT
Objective To explore the association of serum high-sensitivity C reactive protein (hs-CRP) level with leptin in patients with type 2 diabetes mellitns (T2DM). Methods 35 cases of T2DM patients were involved in the study and 16 normal subjects were taken as controls. Fasting serum leptin and CRP were measured .The relationship between them were also analyzed. Results Fasting serum hs-CRP concentration in T2DM group was higher than that in healthy control group, but serum ieptin levels is the same (P > 0.05). Partial correlation analysis demonstrated that fasting hs-CRP level was positively correlated with leptin (r =0.512 ,P =0. 018). Conclusion Fasting serum hs-CRP level is significantly raised in T2DM ,which is associated with leptin. There is chronic inflammatory reaction in T2DM patients,and leptin is possibly involved in inflammatory pathogenesis of T2DM.