現在位置 : RA > C反應蛋白 - C-Reactive Protein- CRP

C反應蛋白 (CRP)
       C反應蛋白 (C-Reactive Protein，CRP)是由肝臟生成的血漿蛋白，主要被當作發炎的指標。C-反應蛋白由五個24千道爾頓原聚體(含206個胺基酸)以非共價連結成為五元體環形結構。C-反應蛋白會結合在死亡細胞或微生物外膜上的磷酸膽鹼(phosphocholine)，以活化補體系統。當體內有急性炎症、細菌感染、組織的損傷時，C-反應蛋白在數小時內出現，而疾病治癒後又很快就消失。
歷史
       由Tillett和Francis在1930年發現，因其對肺炎雙球菌的C-多醣體(C-polysaccharide)會產生沉澱反應，故取名C-反應蛋白。
診斷價值
       C-反應蛋白並不適用於單一疾病的診斷。它的臨床價值主要在於組織損傷的篩檢和監測，應用在判斷病人是否發炎以及診斷發炎性疾病復發的可能性，藉以評估抗發炎藥物治療的成效。另外C-反應蛋白可用來協助類風濕性關節炎的診斷。
心血管疾病的新指標
       自1997年起，美國布雷根婦女醫院的心臟學家瑞德克（Paul M. Ridker）就注意到，一種和發炎有關的分子C反應蛋白（C-reactive protein, CRP）與心臟病有關。近年來的研究結果發現，C-反應蛋白是包括冠心症在內等心血管系統疾病的一種危險因子。
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C反应蛋白(CRP)检测试剂盒产品说明
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What is CRP?
by  Toni Brayer M.D.    05/21/2009      
       C-Reactive Protein (CRP) is a protein found in the blood that indicates "inflammation". It is produced in the liver and during infection, and with some forms of cancer and inflammatory diseases (rheumatoid arthritis, lupus) it can be elevated in a blood test. CRP can also be elevated when there is inflammation in the arteries of the heart and is a "marker" for coronary artery disease.
      High sensitivity CRP (hsCRP) is a common test that is done to assess the risk of heart disease, stroke and diabetes. Like high cholesterol, it is not the disease in itself, but high levels (over 3.0) that indicate a higher risk. Scientists don't know if it is a marker or is a cause of heart disease, but we do know that inflammation of the heart blood vessel walls is always present in heart attack victims. Inflammation is the body's defense against injury or infection and unstable plaques in the coronary artery can rupture and the inflammatory cells rush in to repair. Even people with low cholesterol can have high CRP indicating inflammation.
      There have been numerous studies of CRP in large populations of people, and it's role as a risk for heart attack is well established. Some believe it is even a better predictor than high LDL cholesterol.
      What should be done for people who test high with hsCRP? Lowing other risks (smoking, diabetes control, weight, exercise, high cholesterol) is critical. Aspirin is given as an anti-inflammatory drug and to prevent clotting. Statins (Lipitor, Crestor, Zocor, Pravachol, Mevacor) are potent anti-inflammatory drugs as well as lowering cholesterol. The Jupitor Study, published in the New England Journal of Medicine, showed a reduction in heart attacks in people with high CRP and low cholesterol who were treated with the statin, Crestor.
      Among cardiologists and scientists, the benefits of statin drugs in preventing heart attacks is not a controversy. The Internet is filled with blogs that "Big-Pharma" is out to addict us all but science, not emotion, should be our guide.
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冠心病患者血浆环氧二十碳三烯酸(EET)与高敏C反应蛋白(CRP)及血脂的关系
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CRP可能是比低密度脂蛋白胆固醇更有效的独立的心血管疾病预测指标，可以增加血脂检查、代谢综合症和Framingham危险评分的预后价值。
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C反應蛋白的濃度與侵犯肌肉層的膀胱癌預後有關
翰晃    2008-5-23 
      侵犯型的膀胱癌本身沒有一個很好的腫瘤標記來判斷其預後跟療效。
      最近日本的東京醫科和齒科大學的佐籐醫生與他的研究團隊將肌肉侵犯型的膀胱癌的88名病患經過放射線治療加上兩個療程的cisplatin治療，同時來觀察他們的預後跟CRP的關係，中間追蹤了33個月，其中有19個病患死亡，而五年的存活期是73%，經過放射化學治療前，CRP濃度小於0.5 mg/dL，病患的預後會比較好，其中他也發現有10個病人在合併化學治療與放射線治療以前CRP濃度很高，經過治療後，有6個人恢復正常，其中只有1個人存活，另外4個人在兩年內都死亡。
      根據這份報告，在治療前如果CRP濃度很高的話，即使經過化療與放療後的預後還是比較不好，而佐籐醫師也強調由於侵犯型膀胱癌目前沒有一個很好的腫瘤標記，CRP是可以期待作為一個腫瘤標記的檢查方法，雖然敏感度稍微低了一點，但是檢查價格很便宜，還是值得使用。