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001-es BibID:	BIBFORM037559
Első szerző:	Papp Mária (belgyógyász, gasztroenterológus)
Cím:	Acute phase proteins in the diagnosis and prediction of cirrhosis associated bacterial infections / Papp Maria, Vitalis Zsuzsanna, Altorjay Istvan, Tornai Istvan, Udvardy Miklos, Harsfalvi Jolan, Vida Andras, Kappelmayer Janos, Lakatos Peter L., Antal-Szalmas Peter
Dátum:	2012
ISSN:	1478-3223
Megjegyzések:	BACKGROUND: Bacterial infections are common cause of morbidity and mortality in patients with cirrhosis. The early diagnosis of these infections is rather difficult. AIMS: To assess the accuracy of acute phase proteins in the identification of bacterial infections. METHODS: Concentration of C-reactive protein (CRP), procalcitonin (PCT), lipopolysaccharide-binding protein (LBP), sCD14 and antimicrobial antibodies were measured in serum of 368 well-characterized patients with cirrhosis of whom 139 had documented infection. Clinical data was gathered by reviewing the patients' medical charts. RESULTS: Serum levels of CRP, PCT and LBP were significantly higher in patients with clinically overt infections. Among the markers, CRP - using a 10 mg/L cut-off value- proved to be the most accurate in identifying patients with infection (AUC: 0.93). The accuracy of CRP, however, decreased in advanced stage of the disease, most probably because of the significantly elevated CRP levels in non-infected patients. Combination of CRP and PCT increased the sensitivity and negative predictive value, compared with CRP on its own, by 10 and 5% respectively. During a 3-month follow-up period in patients without overt infections, Kaplan-Meier and proportional Cox-regression analyses showed that a CRP value of >10 mg/L (P = 0.035) was independently associated with a shorter duration to progress to clinically significant bacterial infections. There was no correlation between acute phase protein levels and antimicrobial seroreactivity. CONCLUSIONS: C-reactive protein on its own is a sensitive screening test for the presence of bacterial infections in cirrhosis and is also a useful marker to predict the likelihood of clinically significant bacterial infections in patients without overt infections.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban cirrhosis bacterial infection acute phase proteins Molekuláris Medicina egyetemen (Magyarországon) készült közlemény
Megjelenés:	Liver International 32 : 4 (2012), p. 603-611. -
További szerzők:	Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus) Altorjay István (1954-) (belgyógyász, gasztroenterológus, onkológus) Tornai István (1954-) (belgyógyász, gasztroenterológus) Udvardy Miklós (1947-) (belgyógyász, haematológus) Hársfalvi Jolán (1949-) (klinikai biokémikus) Vida András (1979-) (molekuláris biológus, genetikus) Kappelmayer János (1960-) (laboratóriumi szakorvos) Lakatos Péter (Semmelweis Egyetem) Antal-Szalmás Péter (1968-) (laboratóriumi szakorvos)
Pályázati támogatás:	T046694 OTKA TÁMOP-4.2.1/B-09/1/KONV-2010-0007 TÁMOP Celluláris hematológia - immunológia
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