Usefulness of C-reactive protein in monitoring the severe community-acquired pneumonia clinical course.
Usefulness of C-reactive protein in monitoring the severe community-acquired pneumonia clinical course.
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DOI：
10.1186/cc6105
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
Sabino H
中科院分区：
文献类型：
--
作者：
Coelho L;Póvoa P;Almeida E;Fernandes A;Mealha R;Moreira P;Sabino H
本研究的目的是评估C-反应蛋白水平，体温和白色细胞计数的患者处方抗生素后，以描述严重的社区获得性肺炎的临床解决方案。对53例连续的严重社区获得性肺炎患者进行了研究。每日监测C反应蛋白水平、体温和白色细胞计数。到第3天，C反应蛋白水平为初始水平的0.5倍是不良结局的标志（敏感性，0.91;特异性，0.59）。根据C反应蛋白对抗生素的反应模式，将患者分为快速反应、缓慢反应、无反应和双相反应。C-反应蛋白快反应型和慢反应型患者的存活率分别为96%和74%，而无反应型和双相反应型患者的死亡率分别为100%和33%（P < 0.001）。在抗生素治疗的第3天，C反应蛋白水平较前一天水平降低0.31或更多是预后良好的标志（敏感性，0.75;特异性，0.85）。抗生素处方后每日检测C反应蛋白有助于识别早期3天的严重社区获得性肺炎患者，预后不良。C-反应蛋白对抗生素治疗反应模式的识别有助于识别严重社区获得性肺炎患者的个体临床病程，无论是改善还是恶化，以及改善率。
The aim of the present study was to evaluate the C-reactive protein level, the body temperature and the white cell count in patients after prescription of antibiotics in order to describe the clinical resolution of severe community-acquired pneumonia. A cohort of 53 consecutive patients with severe community-acquired pneumonia was studied. The C-reactive protein levels, body temperature and white cell count were monitored daily. By day 3 a C-reactive protein level 0.5 times the initial level was a marker of poor outcome (sensitivity, 0.91; specificity, 0.59). Patients were divided according to their C-reactive protein patterns of response to antibiotics, into fast response, slow response, nonresponse, and biphasic response. About 96% of patients with a C-reactive protein pattern of fast response and 74% of patients with a slow response pattern survived, whereas those patients with the patterns of nonresponse and of biphasic response had a mortality rate of 100% and 33%, respectively (P < 0.001). On day 3 of antibiotic therapy, a decrease in C-reactive protein levels by 0.31 or more from the previous day's level was a marker of good prognosis (sensitivity, 0.75; specificity, 0.85). Daily C-reactive protein measurement after antibiotic prescription is useful in identification, as early as day 3, of severe community-acquired pneumonia patients with poor outcome. The identification of the C-reactive protein pattern of response to antibiotic therapy was useful in the recognition of the individual clinical course, either improving or worsening, as well as the rate of improvement, in patients with severe community-acquired pneumonia.
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影响因子：
8.8
作者：
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