C-reactive protein and the acute phase reaction in geriatric patients
C-reactive protein and the acute phase reaction in geriatric patients
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DOI：
10.1007/s00391-015-0938-4
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发表时间：
2015-10-01
影响因子：
1.2
通讯作者：
Heppner, Hans Juergen
中科院分区：
文献类型：
--
作者：
Bertsch, Thomas;Triebel, Jakob;Heppner, Hans Juergen
C-反应蛋白（CRP）最初被描述为能够沉淀肺炎球菌的C-多糖的血清组分，是最重要的蛋白质之一，因为在急性期反应中血清浓度升高。急性期反应是机体对各种伤害性刺激（如感染、烧伤、肿瘤和组织创伤）的非特异性反应。CRP在肝实质细胞中由细胞因子合成，所述细胞因子来源于刺激的白细胞并释放到循环中。由于其分子结构和与补体系统的协同作用，它能够沉淀和/或裂解微生物，从而使它们无害。血清CRP浓度的测量可以提供关于诊断和治疗监测的重要信息。由于老年患者的免疫衰老，CRP的合成似乎仅限于炎症刺激;然而，这种现象似乎没有重大的临床意义。尽管引入了新的急性期反应参数，有时具有更好的性能，如白细胞介素-6，降钙素原和可溶性内毒素受体sCD 14，CRP的测量用于诊断和治疗监测仍然是合理的，即使在老年患者中，因为测试是快速的，经济的，几乎无处不在的24小时可用。急性期反应的生化标志物应始终与临床表现及其特定局限性一起解释。
The C-reactive protein (CRP), first described as a serum component capable of precipitating the C-polysaccharide of pneumococci, is one of the most important proteins because the serum concentration rises in the acute phase reaction. The acute phase reaction is the nonspecific reaction of the body to noxious stimuli of the most varied kinds, such as infections, burns, neoplasms and tissue trauma. The CRP is synthesized in liver parenchymal cells by cytokines which are derived from stimulated leucocytes and released into the circulation. Because of its molecular structure and in synergy with the complement system, it is able to precipitate and/or lyse microorganisms, thereby rendering them harmless. Measurement of the serum CRP concentration can provide important information with respect to the diagnosis and monitoring of treatment. Due to immunosenescence in geriatric patients the synthesis of CRP appears to be limited to inflammatory stimuli; however, this phenomenon does not appear to be of major clinical relevance. Despite the introduction of new parameters of the acute phase reaction, sometimes with better performance, such as interleukin-6, procalcitonin and the soluble endotoxin receptor sCD14, measurement of CRP for diagnosis and treatment monitoring is still justified even in geriatric patients as testing is rapid, economic and nearly ubiquitously available round the clock. Biochemical markers of the acute phase reaction should always be interpreted together with the clinical picture and their specific limitations.