CRP ndi Hs-CRP: Makulidwe Awiri a Kuwunika Kutupa

Mapuloteni a C-reactive (CRP), monga chizindikiro choyambirira cha kutupa kwakukulu ndi matenda, mtundu wake wovuta kwambiri wa Hs-CRP (mapuloteni okhudzidwa kwambiri ndi C-reactive) wawonjezeranso malire a ntchito zachipatala. CRP wamba (yokhala ndi 0.5 - 300 mg / L) imayang'ana mwachangu Matenda matenda oopsa, zovuta zapambuyo pa opaleshoni, ndi sepsis, pamene Hs-CRP (yomwe ili ndi chiwerengero cha 0.1 - 10 mg / L) imatha kujambula zizindikiro zotsika kwambiri zotupa, zomwe zimapereka maziko ofunikira kuti athetse chiopsezo cha matenda a mtima, kutupa kosatha, ndi kufufuza anthu omwe ali ndi thanzi labwino. Kugwiritsiridwa ntchito kophatikizana kwa nyukiliya yapawiri kumakwaniritsa kufalikira kokwanira kuyambira kuchizaza chadzidzidzi mpaka kupewedwe koyambirira.

Maumboni okhudzana ndi zochitika zachipatala

1. Kuzindikira Molondola ndi Stratification Wopatsirana Matenda

Kuzindikira kwa mgwirizano wa CRP + PCT: Pamene CRP ≥ 50 mg / L ikuphatikizidwa ndi PCT ≥ 0.5 ng / mL, imasonyeza matenda a bakiteriya (chindunji> 95%);

Kusiyanitsa Matenda a Viral: Pamene CRP imakwezedwa pang'ono (10 - 40 mg / L) ndipo PCT ndi yachibadwa, matenda a tizilombo toyambitsa matenda kapena kutupa kosautsa kuyenera kuonedwa ngati chinthu chofunika kwambiri.

2. Kuwunika Kuopsa kwa Matenda a Mtima

Kuyang'anira Kutupa Kwachidule: CRP ≥ 3 mg / L imasonyeza kutupa kwadongosolo, komwe kumagwirizana kwambiri ndi chiopsezo cha atherosclerosis;

Kuwunika Kuwunika kwa Matenda a Mtima wa Coronary: Odwala omwe ali ndi matenda aakulu a coronary syndrome, ngati CRP idakali pamwamba (> 10 mg / L), imasonyeza kuti pali vuto lalikulu ndipo limafuna chithandizo chamankhwala choletsa kutupa.

3. Kusamalira Matenda a Autoimmune

Kutsata kwamphamvu kwa zochitika zotupa: Mlingo wa CRP mwa odwala omwe ali ndi Matenda a Rheumatoid zimagwirizana bwino ndi ntchito za matenda (mtengo wamtengo wapatali: CRP

Kuwunika kwa chithandizo chamankhwala: A ≥ 50% kuchepa kwa CRP pambuyo pa biologic mankhwala amasonyeza kuyankha kwabwino kwachirengedwe.

4. Pambuyo pa Opaleshoni ndi Odwala Kwambiri

Chenjezo la matenda a postoperative: Kuchedwetsa kuchepa kwa mlingo wapamwamba wa CRP kapena kuwonjezeka kosalekeza (> 100 mg / L) pambuyo pa opaleshoni kumasonyeza chiopsezo cha zovuta;

Kuzindikiritsa koyambirira kwa sepsis: CRP> 100 mg / L pamodzi ndi PCT ≥ 2 ng / mL ikhoza kuyambitsa mwamsanga chithandizo chamankhwala.

5. Kukonzekera Kwachiopsezo ndi Mankhwala Oteteza Matenda a Mtima

Kuwunika kwa anthu asymptomatic: Hs-CRP ≥ 2 mg / L imasonyeza kuwirikiza kawiri kwa chiopsezo cha zochitika za mtima. Kuphatikizidwa ndi mbiri ya lipid (monga LDL-C), imatha kukhathamiritsa njira yolosera zachiwopsezo (monga momwe zimalimbikitsira malangizo a ACC/AHA);

Kuwunika kwa zotsatirapo: Pambuyo pa chithandizo cha statin, Hs-CRP imachepetsedwa kufika pa

Kwa anthu matenda otupa komanso kuwunika kwa CVD akulimbikitsidwa. Motere:

6. Kuwongolera Matenda a Metabolic Matenda

Chenjezo la Kusokonezeka kwa Matenda a Shuga: Kukwera kosalekeza kwa Hs-CRP (> 3 mg / L) kwa odwala omwe ali ndi matenda a shuga a mtundu wa 2 kumasonyeza chiopsezo cha microvascular and cardiovascular aimpso, zomwe zimafuna kuwongolera kokwanira;

Kuyang'anira Matenda Okhudzana ndi Kunenepa Kwambiri: Mlingo wa Hs-CRP umagwirizana bwino ndi kuchulukitsidwa kwamafuta a visceral, kupereka maziko ochulukirapo a kulowererapo kwa moyo.

7. Kuzindikira Molondola ndi Kuchiza Matenda a Autoimmune

Kuzindikiritsa kutupa kwa subclinical: Kuzindikira kwa Hs-CRP kungathandize kuzindikira zilonda zam'mimba (monga kukhudzidwa kwa mtima) kwa odwala omwe ali ndi matenda a nyamakazi atangoyamba kumene, kutsogolera mankhwala osiyanasiyana ophatikizana;

Kusintha kwamphamvu kwa zolinga za chithandizo: Pansi pa chithandizo chophatikizidwa ndi biologics, mlingo wa Hs-CRP wochepera 1 mg/L ukhoza kugwiritsidwa ntchito ngati malo owonetsera kuti athetse kutupa kwathunthu.

Lamuno (Fluorescence immunoassay nsanja): CRP/Hs-CRP wapawiri mode, kukhazikitsa makampani muyezo watsopano

Kuzindikira kwapawiri-pakati ndi kusintha kosinthika: Pulatifomu yomweyi imathandizira mayeso wamba a CRP (acute phase) ndi Hs-CRP (chronic phase). Pongosintha makadi a reagent, zotsatira zimatha kutulutsa nthawi imodzi mkati mwa mphindi 15, kukwaniritsa zosowa zosiyanasiyana zachipatala.
Chitsimikizo chapamwamba chapamwamba cha ntchito: Kutengeka kwa Hs-CRP kufika ku 0.5 mg / L, kuzindikiritsa molondola zizindikiro zochepetsera zowonongeka;

Mzere wa mzere: CRP 0.5-200 mg / L, kugwirizanitsa mosasunthika zochitika zadzidzidzi ndi matenda aakulu.

Mapangidwe a Compact: Oyenera zochitika zosiyanasiyana zogwiritsira ntchito.

Kuchokera ku Chithandizo cha Emergency to Prevention: Kufotokozeranso Kuwongolera Kutupa

Lamuno amaphatikizira kuzindikira kwapawiri kwa CRP ndi Hs-CRP, ndikudutsa malire akuwunika kwachikhalidwe cha kutupa. Pazochitika zadzidzidzi, imazindikira msanga gwero la matenda ndikuwongolera kugwiritsa ntchito maantibayotiki; m'munda wa matenda osachiritsika, amaneneratu zochitika zamtima zaka 10 pasadakhale, kulimbikitsa kukhazikitsidwa kwa "kupewa matenda asanachitike". Kukonzekera kumeneku sikungowonjezera luso la kugaŵidwa kwa zinthu pazaumoyo komanso kumathandizira kasamalidwe kaumoyo wa odwala kwa moyo wawo wonse kudzera mu data yolondola, kupereka chithandizo chaukadaulo pa kapewedwe kazaumoyo wa anthu.