C-reactive protein (CRP) is a gold marker that is responsible for the presence of inflammatory processes in the body.

An analysis for this element allows you to identify an infection or virus in the body at an early stage.

Its increase occurs after 6 hours from the beginning inflammatory process but further testing may be required to make an accurate diagnosis.

What it is?

C-reactive protein (CRP) is an indicator of acute inflammation. It is produced by the liver, and this is carried out during necrotic and inflammatory processes in any part of the body. AT clinical diagnostics it is used along with ESR, but has a higher sensitivity.

A reactive protein can only be detected using a biochemical blood test. It increases in the blood after 6-12 hours from the onset of the pathological process. CRP responds well to therapeutic methods, which makes it possible to follow the course of treatment with a simple analysis.

Unlike ESR, C-reactive protein takes on normal values ​​immediately after the removal of inflammatory processes and the normalization of the patient's condition. High ESR values, even after successful treatment, can persist for a month or more.

Action C - reactive protein (protein)

Indications for carrying out

Most often, the determination of the amount of reactive protein is prescribed for:

• Calculation of the risks of occurrence of pathologies of the heart and blood vessels.
• After medical examination of elderly patients.
• postoperative period.
• Evaluation of the effectiveness of drug therapy.
• Diagnosis of autoimmune and rheumatic diseases.
• Tumor suspected.
• infectious diseases.

A laboratory study of CRP is usually prescribed for acute inflammatory diseases of an infectious nature. It also assists in the detection of pathologies of an autoimmune and rheumatic nature. It is prescribed for suspected tumors and cancer.

How is C-reactive protein determined?

The determination of C-reactive protein occurs through a biochemical blood test. For this, a latex test based on latex agglutination is used, which allows you to get a result in less than half an hour.

You can take the analysis in almost any laboratory. One of the most popular laboratories in all cities of Russia is Invitro, where specialists will help you get the results within a few hours after blood sampling.

Reactive protein concentration plays an important role in the diagnosis of cardiovascular pathologies .

In this case, cardiologists are not satisfied with conventional methods for detecting reactive protein, and the use of high-precision hs-CRP measurement, which is combined with a lipid spectrum, is required.

A similar study is carried out with:

• Pathologies of the excretory system.
• Difficult pregnancy.
• diabetes mellitus.
• Lupus erythematosus.

Functions

Reactive protein is an immune stimulant that is produced during acute inflammatory processes.

In the process of inflammation, a kind of barrier arises that localizes microbes at the sites of their invasion.

This prevents them from entering the bloodstream and causing further infection. At this time, pathogens begin to be produced that destroy the infection, during which a reactive protein is released.

The increase in reactive protein occurs after 6 hours from the onset of inflammation and reaches its maximum on the 3rd day. During acute infectious pathologies, the level can exceed the permissible value by 10,000 times..

After the inflammatory reaction stops, the production of reactive protein stops, and its concentration in the blood decreases.

SRB perform the following functions:

• Accelerate the mobility of leukocytes.
• Activate the complement system.
• Produce interleukins.
• Accelerate phagocytosis.
• Interact with B- and T-lymphocytes.

Functions of C - reactive protein

C-reactive protein normal

The change in indicators is carried out in mg. per litre. If there are no inflammatory processes in the body of an adult, the reactive protein is not found in his blood. But this does not mean that it does not exist in the body at all - its concentration is so low that tests cannot determine it.

The norms for adults and children are presented in the table:

When the reactive protein is exceeded by more than 10, a number of other studies are carried out to determine the cause of the inflammatory process. It is necessary to be especially careful at high rates in newborns and children, which indicate the presence of a malfunction in the body.

The erythrocyte sedimentation rate (ESR) also detects inflammation, but not at an early stage. The norms of ESR indicators have some differences:

Elevated CRP is involved in the formation of atherosclerosis

ESR is older and simple method detection of inflammatory processes, which is still used in many laboratories today. The test for creative protein is more accurate and allows you to get a reliable result already at an early stage of the inflammatory process.

The advantages of the analysis for C - reactive protein in comparison with the ESR are indicated in the table:

Differential diagnosis is presented in the table:

Reasons for the increase

Elevated reactive protein indicates the presence of inflammatory and infectious diseases. Depending on the degree of increase in indicators, one or another pathology can be suspected.

The reasons	Index, mg/l
Acute infectious infection (postoperative or hospital)	80-1000
Acute viral infection	10-30
Exacerbation of a chronic inflammatory disease (arthritis, vasculitis, Crohn's disease)	40-200
Slow chronic disease + autoimmune pathologies	10-30
Non-infectious tissue lesions (trauma, burns, diabetes, postoperative period, heart attack, atherosclerosis)	Depends on the severity of tissue damage (the higher it is, the greater the CRP). It can go up to 300.
Malignant tumors	An increase in CRP in the blood means that the disease is progressing and requires urgent treatment.

There are a lot of reasons for the increase in c-reactive protein, and the more serious the pathology, the higher the rates.

High protein levels may indicate:

After surgical interventions, the value of CRP is especially increased in the first hours, after which there is a rapid decrease. Even excess body weight can cause an increase in reactive protein.

The most common reasons for a slight increase include:

Pregnancy.

Taking hormonal drugs.

Smoking.

The increase in CRP in tonsillitis is indicated in the table:

Most often, the reactive protein rises due to inflammatory diseases of an infectious nature.

You can determine the exact reason for the increase in performance by additional symptoms, and if they are completely absent, the specialist will offer to pass a number of other studies:

Highly sensitive hs-CRP test

To detect pathologies of the cardiovascular system, a special highly sensitive hs-CRP test is performed. It allows you to detect even a slight increase in protein, which undoubtedly helps in calculating the risks of diseases of the heart and blood vessels.

In women and men, determining the risk of cardiovascular pathologies is most often carried out using a cholesterol test. Hs-CRP test shows more accurate data and helps to start treatment at an early stage. It is indispensable in monitoring the effectiveness of treatment and the course of the disease.

Analysis for c-reactive protein is important for diagnosis and detection of malfunctions in the body. It allows you to determine the presence of serious pathologies at the initial stage and monitor the effectiveness of therapeutic measures. Unlike ESR, CRP analysis gives a more accurate result and monitors the slightest changes in the body.

Video: C reactive protein 10

Velkov VV, candidate of biological sciences,
CJSC "DIACON", Pushchino, Moscow region, Prospekt Nauki, 5.

More than 75 years have passed since the discovery. Over the years, it has become the "golden" marker of clinical laboratory diagnostics.

The CRP molecule consists of 5 identical subunits. On one surface of the molecule there is a site with which Ca ions bind. After combining with Ca, CRP acquires the ability to bind ligands (in particular, phosphocholine, a hydrophobic component of cell membranes). On the other surface of the molecule, there is another site - it provides binding of receptors and C1q complement. Thus, with one of its sites, SRB “recognizes the enemy” - a foreign antigen, and with the other it attracts means to destroy it. In general, CRP binds to bacterial polysaccharides and glycolipids, to damaged membranes, and to exposed nuclear antigens. And this, in turn, leads to binding to C1q and activation of the classical complement cascade, which, as a result, causes the fixation of cleaved phagolytic complement products.

It is not surprising that such a universal and “golden” marker as CRP is the object of numerous studies, the results of which may seem quite unexpected. But this is only at first glance.

CRP and socioeconomic status. Statistics show that in people with low socioeconomic status, the consequences of cardiovascular diseases are more severe than in those who do not fall into this social category. Low socioeconomic status is usually associated with chronic diseases and, in particular, with low-grade inflammatory processes. And they, as mentioned, can be the cause of atherosclerosis. Indeed, 15.7% of those living below the poverty line had very high levels of CRP, over 10.0 mg/l, and among those above the poverty line, only 9.1% had CRP above 10.0 mg. / l.

Another study showed that out of 985 individuals with CVD, 390 had elevated CRP levels (above 3 mg/l), while among them 51% did not have completed secondary education and only 30% graduated from college. According to the financial situation - among those who had a high CRP, 42% had an annual income of less than $20,000 per year and 28% had an annual income of $50,000 or more. After adjusting for traditional risk factors, it was concluded that the inflammatory process is indeed associated with negative cardiovascular outcomes, predominantly in individuals with low socioeconomic status.

Moreover, the values ​​of the indicator of the level of education turned out to be inversely proportional to the levels of DRR. It is believed that this relationship "may be a biological mechanism that predisposes individuals of low socioeconomic status to CVD." Low socioeconomic status and harsh family conditions lead to an increase in CRP already in childhood. “Psychosocial” stresses and feelings of loneliness increase CRP levels. As it turned out, the lower the quantitative indicator of social integration (calculated according to the methodology and taking into account: marital status, the number of contacts with family members and relatives, the frequency of attendance at religious services, participation in voluntary public organizations, etc.), the higher the level of CRR. But, what is important, only in older men, but not in women and not in young men.

CRP and depression. In men, CRP levels greater than 1.0 mg/l were found to be associated with a 1.7-fold increased likelihood of depressive episodes and a 3.1-fold increase in their recurrence. At the level of CRP above 3.0 mg/l, the probability of depression recurrence increased by 4.1 times. No such pattern was found in women. A positive association between depressive symptoms and CRP levels was also found in another study. After adjusting for traditional risk factors, it has been shown that part of this association may be mediated by obesity, and in particular by elevated triglyceride levels. Depression is also observed in 20-30% of patients with end-stage renal disease and has been shown to be associated with increased mortality. It turned out that in patients subject to hemodialysis and depression, the level of CRP was 10.7+/-4.6 mg/l, and in patients on hemodialysis, but without depression, the level of CRP was 45+/-3.8 mg/l.

CRP and obesity. Indeed, CRP levels are positively associated with anthropometric indicators of general and central abdominal obesity. Obesity increases CRP levels to 0.75+/-1.04 mg/l (in the control group 0.41+/-0.75 mg/l). In healthy children, CRP is 0.5 mg/l, in obese children it is 2.3 mg/l. It seems that CRP can also be synthesized in adipose cells, as evidenced by the detection of CRP gene mRNA synthesized in adipocytes.

Is an increase in CRP levels a consequence of obesity or its cause? Obviously, at least one of the reasons. In 2006, one more and completely unexpected one was added to the list of numerous functions of SRP. It turned out that one of the causes of obesity is the interaction of the hormone leptin with CRP. Leptin is synthesized by adipose tissue cells, so its level increases with weight gain. When leptin binds to specific receptors located in the hypothalamus, the body receives a signal to stop eating food and begin to expend stored energy. Despite the fact that in the body of obese people an increased amount of leptin is produced, for some reason it does not have the desired effect. It turned out that the reason for this is the binding of leptin to CRP, the level of which in the blood of obese people is also usually elevated. The administration of human leptin for 6 days to mice that have receptors for this hormone, but are unable to produce it, led to a decrease in the animals' appetite, weight loss, and normalization of blood glucose levels. The combined administration of leptin and CRP, as well as CRP alone, did not lead to changes in the behavior of mice, they continued to eat a lot and got fat. In another line of experiments, it was found that exposure to leptin enhances CRP production by liver cells, suggesting the possibility of appetite regulation through a feedback mechanism, except for the brain and leptin-synthesizing adipose tissue, which also includes the liver. In general, it is precisely because of CRP in obesity that a positive feedback occurs - “the effect stimulates its cause.” More obesity - more leptin and CRP are synthesized in fat cells, CRP inactivates leptin, this increases appetite, which increases obesity, and so on

But there is also good news. Weight loss (diet, exercise) reduces CRP levels by 30%. At the same time, body mass index values ​​decreased by 7%, free fatty acid concentrations decreased by 30%, fasting insulin levels decreased by 15%, and HDL-C levels increased by 8%. No changes were observed in triglyceride and LDL-C concentrations. The results of a similar study are even more encouraging. Three months exercise led obese individuals not only to reduce weight, total cholesterol and LDL-C, but also to reduce CRP.

Obesity is known to be closely associated with metabolic syndrome.

CRP and metabolic syndrome. Data on the association of elevated CRP levels with metabolic syndrome (MS) are numerous and are in good agreement with each other. MS induces sluggish inflammation, which, in turn, is a risk factor for CVD. In adult patients with MS, the risk of having CRP above 3.0 mg/l is 4 times higher than in healthy individuals. In MS, elevated CRP is associated with increased risk of CVD and diabetes. It was shown that in patients with MS, CRP levels were 3.8 mg/l (in control - 1.4 mg/l). Among patients with MS, CRP was elevated in 38.4% of individuals, and among those without MS, CRP was elevated only in 10.3%.

An increase in the severity of MS is associated with an increase in CRP. The main contributors to this increase are increases in central obesity and blood pressure. Even a seemingly insignificant increase in CRP from 1.36 to 2.34 mg/l is already characteristic of diagnosed MS. In the presence of central obesity, the level of CRP was 2.45 mg/l (in the control group - 1.24). The more MS factors available, the higher the CRP. It is clear that "an increase in the severity of MS is associated with an increase in CRP levels." In another study, a positive relationship was observed between CRP levels, body mass index values, waist circumference, and triglyceride levels. negative connection noted between the concentrations of CRP and HDL-C. These data are well supported. In patients with MS, elevated levels of CRP (10.6+/-5.5 mg/l, control group - 3.5+/-0.8) were also positively associated with body mass index, waist circumference, total cholesterol, X -LDL, triglycerides, fasting glucose concentration. But no relationship with concentrations with HDL-C was found.

CRP and hypertension. Indeed, elevated CRP levels are associated with hypertension and high blood pressure. It has recently been shown that for both men and women with hypertension, the CRP level was 2.3+/-0.07 mg/L. while in the control group it was 1.6+/-0.07 mg/l. However, it should be borne in mind that elevated levels of CRP are not the cause of hypertension.

CRP and type 1 diabetes. Diabetes is closely associated with MS. In young patients with type 1 diabetes (DM I), but who did not have its complications, the CRP level was 3 times higher than in the control group, and in people with DM I and with complications it was 5 times higher. It is believed that "hsCRP is a predictor of complications of DM I".

CRP and type 2 diabetes. In people with type 2 diabetes (DM II), the most common comorbidities are CVD associated with atherosclerosis. They are the main cause of death in DM II. In general, the risk of CVD in DM II is 2-4 times higher than in non-diabetics. Accumulating evidence suggests that cytokine-induced OP, dyslipidemia, and atherosclerosis are indeed associated with insulin resistance (IR) and elevated OP proteins, especially with elevated CRP. As a rule, in IR, CRP is increased to 7.3 mg/ml (in the control group 4.4 mg/l), while the level of another OF protein, ferritin, is also increased, 124.5 ng/ml (in the control group 80.1 ng/ml). It is believed that “identification of subclinical chronic inflammation by determining CRP and ferritin is an indication of the need for active therapy aimed at reducing the risk of developing CVD in type II diabetes.” Significantly, IR is strongly associated with elevated CRP in adults, but not in children (10-16 years). It is believed that the development of IR preceded an increase in CRP with the progression of MS.

CRP levels were studied in individuals with DM II who had AMI (Group A) and in individuals who had AMI but did not have DM II (Group B). Immediately after MI, CRP levels in groups A and B were 6.95 and 5.1 mg/L, respectively. 60 days after MI, CRP levels were 4.23 mg/l and 1.46 mg/l, respectively. It is believed that "in patients with type 2 diabetes who have had AMI, a significantly elevated CRP is an indicator of persistent endothelial dysfunction and, as a result, a poor prognosis."

Another study examined CRP levels in individuals with type II diabetes, in individuals with impaired glucose tolerance (IGT), and in individuals with normal glucose tolerance. The highest CRP was in persons with DM II, and the lowest in persons with normal glucose tolerance. IGT has also been shown to be associated with elevated CRP in CVD patients without diabetes. It is believed that "inflammation, atherosclerosis and IGT are closely related even in those who do not (yet) have diabetes."

How accurately does elevated CRP predict acute coronary events in T2DM? A total of 1059 patients with DM II were followed up for 7 years, 878 of whom did not have MI at baseline. During the observation period, 157 individuals died from CVD, 254 had fatal or non-fatal MI. In patients with CRP above 3 mg/l, the risk of death from myocardial infarction was 19.8%, and with CRP below 3 mg/l, it was 12.9%. independent risk factor for CVD mortality.

Another study followed 3037 individuals for 7 years. MS and DM II were diagnosed in 24% of patients. In women with MS, CRP levels were higher than in men and amounted to 7.8 and 4.6 mg/l, respectively. It has been shown that in DM II the risks of CVD are increased by 2-4 times even after adjusting for sex and age. It is believed that "the pathogenesis of DM II is strongly associated with the induction of OP and that MS and elevated CRP are an independent predictor of new cardiovascular events."

CRP and asthma. Asthma is characterized by chronic inflammation in the airways. It was found that in patients with asthma, CRP was 1.33+/-1.48 mg/l, in the control group 0.21+/-0.30 mg/l. It is believed that "increased CRP is associated with bronchial obstruction and inflammation in the bronchi."

CRP in gastroenterological diseases. Elevated CRP is a marker of Crohn's disease and acute pancreatitis, and indicators of such an increase indicate the severity of the disease. However, with ulcerative colitis, an increase in CRP is not observed. The results of CRP monitoring in patients with Crohn's disease and acute pancreatitis may predict relapses of these diseases.

CRP and colorectal cancer. An 11.5-year study of 38,373 people found that elevated CRP, after adjusting for other risk factors, was indeed associated with an increased risk of colorectal cancer, with poor prognosis, and poor prognosis after resection. It is believed that inflammation may be associated with early stages development of a colon tumor.

CRP and hemodialysis. During hemodialysis, 35-65% of patients experience chronic inflammation, which is characterized by an increase in CRP and pro-inflammatory cytokines. It is assumed that in this case, the following may occur: 1) complement formation upon contact of plasma proteins with the membrane, 2) reverse filtration of contaminated dialysate into the bloodstream, 3) direct contact of blood cells with the dialysis membrane. A single determination of CRP is an accurate predictor of mortality in these patients. With CRP above 10 / mg / l, the risk of mortality within 5 years increases by 3.5 times.

Does a single measurement of CRP reliably predict mortality in patients on dialysis? After all, with concomitant infections, CRP temporarily increases. Can one therefore unequivocally trust single measurements of CRP? We studied the predictive value of single and multiple determinations of CRP in 635 patients who were on hemodialysis in 1997-2002. By 2002, 247 patients had died, of which 107 patients (47.8%) died from CVD. It turned out that both single and repeated elevated levels of CRP (above 10 mg/l) were associated with both CVD and non-CVD mortality.

The highly sensitive measurement of CRP, both before and after hemodialysis, has confidently entered the practice of modern nephrology. Recently, it has been convincingly shown that an increase in CRP during hemodialysis by 1 mg/l increases the risk of mortality by 9%, an increase in CRP by 3 mg/l increases the risk of mortality by 30%. It is very significant that if after hemodialysis the level of CRP does not decrease, this is a bad prognosis! Another study states that if after hemodialysis CRP is higher than 8.0 mg / l, the risk of mortality is approximately doubled.

Thrombosis of arteriovenous fistulas (TAF) is one of the most common diseases in patients on hemodialysis. At the same time, the development of TAF is combined with hyperplasia of the vascular intima. It has been shown that elevated CRP is a predictor of the development of vascular intimal hyperplasia, which contributes to the development of stenosis or thrombosis in patients with native arteriovenous fistula.

In general, the level of CRP is not only a predictor of CVD and mortality in patients on hemodialysis, but also predicts the development of fistula thrombosis in this group of patients. Patients with CRP above 8 mg/l are highly prone to the formation of TAF. It is believed that "elevated CRP is not only a predictor of CVD in hemodialysis, but also a predictor of the development of TAF."

As mentioned, one of possible causes the occurrence of inflammation during hemodialysis is the contact of blood with the dialysis membrane. Is there a dependence of CRP levels on different types of hemodialysis and on different types of membranes? Investigated 247 patients, of which 127 were subjected to standard dialysis and 120 hemodiafiltration (hemodiafiltration). used in dialysis different types membranes. In 47% of clinically stable patients, unexpectedly high (more than 5 mg / l) CRP was found. At the same time, CRP was higher with hemodiafiltration than with standard hemodialysis. The highest CRP was observed with the Cuprophane membrane. It is believed that "it is necessary to develop new synthetic membranes, the use of which would not be associated with an increase in CRP."

In many kidney transplant patients, mortality is not related to transplant rejection, but to CVD. Inflammation in these patients is directly related to atherosclerosis and it can cause both rejection of the transplanted kidney and CVD. An elevated pre-transplant CRP level is a predictor of acute rejection and chronic transplant nephropathy.

CRP and oral contraceptives. It should be borne in mind that oral contraceptives increase CRP from 0.45 mg / l to 1.48-2.02 mg / l. This is thought to be related to the effect of contraceptives on the liver (where CRP is synthesized), but not to the induction of low-grade inflammation.

CRP and hormones. Exogenous estrogen and estrogen + medroxyprogesterone increase CRP by 44.7% and 54.7%, respectively, but this increase is not associated with the development of atherosclerosis. Elevated Levels endogenous sex hormones can also affect CRP. Thus, in postmenopausal women (when estrone is the dominant circulating hormone in terms of concentration), elevated CRP was positively associated with estrone and anrostenedione levels, but negatively associated with sex hormone-binding globulin levels.

CRP and pregnancy. Pregnant women with elevated CRP during weeks 5-19 of pregnancy are at high risk of preterm birth. In full-term pregnancy, CRP was 2.4 mg/l, in case of preterm birth - 3.2 mg/l. And with CRP - 8 mg / l and above, the probability of preterm birth increases by 2.5 times, regardless of other risk factors. In pregnant women with periodontitis, CRP is elevated and averages 2.46 mg/l, while in pregnant women who did not have this disease, CRP was 1.49 mg/l. It is believed that "periodontitis, which increases CRP during pregnancy, may be associated with adverse pregnancy outcomes."

CRP in women who were breastfed during infancy. Breastfeeding a child determines what his CRP will be in adulthood. If the girls were breastfed, then after 26 years their CRP was 2.22 mg / l, and total cholesterol - 4.62, if not fed - CRP was 3.95 mg / l, and total cholesterol - 5.04. No such pattern was found in boys. It is believed that “if newborn girls are breastfed, then they will have a low CRP and a low risk of CVD in adulthood.”

Why should CRP concentrations be measured? In general, measurements of CRP levels should not be used for diagnosis per se, but rather

1) to assess the severity of inflammatory processes (concentration range from 10 mg / l and above) and,
2) to assess the risks associated with sluggish inflammatory processes (concentration range - less than 10 mg/l).

CRP in the inflammatory range should be measured for:

1) determining the severity of inflammatory processes caused by bacterial and viral infections,
2) monitoring changes in the severity of such processes in order to correct their therapy,
3) monitoring the patient's condition after surgical intervention,
4) monitoring the rejection of the transplanted kidney,
5) monitoring the patient's condition after MI or ischemic stroke.

The highly sensitive measurement of CRP should be used to assess risks for:
1) progression of atherosclerosis,
2) MI and ischemic strokes,
3) complications after hemodialysis,
4) complications of diabetes,
5) pathologies of pregnancy.

The full text containing the bibliography (52 citations) is

If in the human body there are any pathological changes tissues, then a biochemical blood test always shows the presence of a special C-reactive protein (CRP). This substance appears approximately four hours after the onset of any inflammation, therefore it is considered a marker of the inflammatory process. When C-reactive protein is elevated, this confirms tissue damage, but does not allow a specific cause to be established.

This substance is produced by the liver. It is an activator of the immune system, the main functions of which are related to protection. human body from injuries of various etiologies.

Against the background of any tissue damage, inflammation always begins. At this point, leukocytes produce special substances called interleukins. It is they, being components of the immune system, that stimulate the production of C-reactive protein by the liver.

Features of the analysis of C-reactive protein

C-reactive protein is attached to the surface of pathogens, being a kind of label for the immune system. As a result, the protective system launches certain sequential reactions that are aimed at eliminating the pathogen. Directly at the site of tissue damage, CRP binds to decay products and this protects the human body from their negative effects.

A feature of the analysis for CRP is that it does not give false positive results. But to obtain more accurate clinical information, the study is recommended to be carried out simultaneously with the ESR test.

When is an analysis ordered?

Today, a blood test to detect an increased concentration of CRP is prescribed not only to fix the existing inflammation. It is used to assess the risk of developing cardiovascular pathologies in apparently healthy people.

That is, a blood test can be preventive in nature. Most often, such a need arises to assess the health status of older people. An increased amount of C-reactive protein may indicate the development of the following pathologies:

• The development of coronary heart disease against the background of existing atherosclerosis.
• The occurrence of exacerbations after surgical operations, for example, after bypass surgery or angioplasty.
• The development of malignant neoplasms.

An analysis is also prescribed to identify the risks of a recurrent heart attack or stroke. This study allows us to evaluate the effectiveness of antibiotic therapy.

SRO norms

• In adult men and women - 10 mg / l.
• In children - 10 mg / l.
• In newborns - 4 mg / l.
• In pregnant women - 20 mg / l.

The reference value for adults is less than 5 mg/l. It eliminates the development of the inflammatory process in the human body.

Causes of an increase in the concentration of CRP

A high rate of reactive protein is observed with bacterial infection. When the inflammatory process begins, the amount of the substance increases tens, and sometimes hundreds of times.

In this case, C-reactive protein in the blood serum can be increased up to 1000 mg / l. This indicator is an indication that it is urgent to start treatment with antibacterial drugs. An increased CRP is most often noted in the following cases:

• With viral infection, but in this case, the indicator increases slightly.
• With autoimmune diseases, in particular with rheumatoid arthritis, Crohn's disease, systemic vasculitis. In such cases, the higher the indicator, the more severe the form of the disease.
• With the development of a heart attack. As a rule, the indicator rises 18-32 hours after the attack, then gradually decreases by the twentieth day and is completely normal by the fortieth day. A very high concentration of CRP in the blood indicates an unfavorable prognosis.
• With tissue necrosis as a result of the decay of tumors.
• In case of tissue damage due to injury, burns or frostbite.
• For chronic muscle pain.

• With oncological diseases.
• At diabetes.
• With arterial hypertension.
• With hormonal imbalance.
• In the presence of diseases digestive system especially in acute pancreatitis.

C-reactive protein in the blood is always elevated in the postoperative period, but during the normal recovery process, its concentration decreases sharply. If elevated rates persist long time, this indicates the development of complications or indicates rejection of transplanted tissues.

Also, significant upward deviations of CRP are observed in women who are carrying a child, when there is a threat of preterm birth. C-reactive protein may be elevated in the blood due to various subjective factors. The main ones are:

• Large physical activity for several days before donating blood.
• Hormonal contraceptives.
• Overweight.
• Compliance with a protein diet, which athletes often adhere to.
• Depression and insomnia.
• Tobacco smoking.

Features of increasing CRP in children

C-reactive protein can be elevated in the blood of children, and the reasons for this are the same as in adults. Therefore, for the diagnosis of the inflammatory process in a child, this analysis is of high value.

You should be aware that in a newborn, protein may not appear in the blood even in the presence of sepsis. This pathology is characterized by a strong inflammatory process in one or more organs. Sepsis is always accompanied high temperature, which becomes the main indicator for the adoption of urgent measures.

The absence of CRP in the blood serum of newborns with obvious symptoms of inflammation is due to the fact that in infants the liver cannot work at full capacity, which means it does not synthesize protein. But if the analysis showed that the level of C-reactive protein in the blood is increased, then antimicrobial therapy should be urgently carried out.

When children are sick with rubella, chickenpox or measles, a blood test will also necessarily show an increase in CRP levels. Moreover, the concentration of the substance begins to rise sharply in the first days of the disease, when there is a fever and an increase in body temperature. After recovery, the indicators quickly decrease to normal.

An increase in CRP in the blood after any operation is an indicator of infection of the child's body. If the level of a substance in the blood remains high despite antibiotic therapy, this indicates the development of complications.

Therapy for elevated CRP

An elevated concentration of CRP, confirmed by a biochemical blood test, is not an accurate confirmation of a specific disease. This is an indicator of the development of a possible pathology. With what it can be connected can be determined only on the basis of additional research.

It is noteworthy that if the therapy is chosen correctly, then the level of C-reactive protein quickly decreases and returns to normal. For example, with the correct use of antibacterial drugs, positive result marked by a decrease in the level of CRP already during the day. If there are no obvious signs of bacterial or viral infection, but the analysis showed an increased concentration of CRP in the blood, then consultation with an oncologist is required.

In order for any prescribed therapy to be effective, the rules must be followed. healthy eating And do not forget about moderate physical activity. In addition, you need to try to eradicate existing bad habits. Such standard rules will contribute to the rapid recovery and preservation of health for many years.

At the first sign of a serious illness in a person, the doctor may prescribe a blood test for CRP. There is no reason to be afraid, because this is the main indicator on which diagnostics and further treatment will be based. What is the decoding and regulatory indicators of C-reactive protei - read more.

What is SRP

C-reactive protein is an enzyme secreted by the liver during the acute phase of the inflammatory process or the onset of a tumor. With any damage to the internal soft tissues, the body turns on a protective scheme of existence. CRP begins to be produced in increased quantities, forcing the immune system to work at full capacity. The more complex the person's condition, the higher the acute phase protein index.

What does CRP show in a blood test?

Having received the result of laboratory tests, you need to deal with CRP in the blood - what it is. An increased indicator will not indicate the source of the cause, but it can be used to accurately determine that health problems have begun. Any inflammation that is at the peak of the process will show CRP in a blood test above the norm, sometimes tens of times.

A sharp jump in protein often occurs with sepsis (blood poisoning), necrosis (death of living tissue), the appearance of a malignant neoplasm, or a course of biochemistry to combat the spread of metastases, tuberculosis, meningitis, after a heart attack, burns, and diabetes mellitus. Carrying out monitoring of the patient's condition, the doctor regularly prescribes blood donation to exclude the presence of a large number squirrel. This happens in such cases:

• risk of death after angioplasty;
• assessment of the risk of metastases in oncological diseases, after undergoing biochemistry;
• risk of restenosis after surgery;
• exclusion of the development of neutropenia;
• the risk of recurrent myocardial infarction in people with coronary heart disease;
• preventive examination of elderly patients;
• treatment aimed at controlling the content and lowering cholesterol levels.

The norm of CRP in the blood

Modern techniques and the use of the latest reagents make it possible to determine the number of proteins. Different hospitals may issue results based on data from 0 to 0.3-0.5 mg / l, which are considered the norm for CRP in the blood. Having received the answer, you need to look at the reference value of this laboratory, which is based on a specific reagent. More recently, there was no numerical indicator. The result could look like a score of "negative" - ​​no protein detected, or "positive" from one to four pluses.

Among women

During pregnancy or taking contraceptive medications, women experience a hormonal imbalance, so when taking a blood test, you need to warn about these factors so that the results are “clean”. The body is a complex mechanism, so the norm of CRP in women may differ from the generally accepted one. So during the bearing of a child, an increase in indicators up to 3.0 mg / l will be considered the norm. After 50 years, in women, the result should be "negative" or in the range of 0-0.5 mg / l.

In children

The child's body grows and develops rapidly, especially in the first years of life. The norm of CRP in children of different ages will be different. So in a newborn baby, the indicator is 0.6 mg / l, and a year later - 1.6 mg / l. The average value, based on the age of the child, ranges from 0 to 10 mg / l. After any surgical intervention, children are tested for CRP on the 3rd-5th day. If the result is exceeded, then this means that an infection has occurred and urgent antibiotic therapy is needed. Particular attention should be paid to the exclusion of neonatal sepsis.

CRP in the blood is elevated

What is CRP in a biochemical blood test and why is it elevated? There are a number of causes and diseases that can give such results already in the first hours. In parallel, an analysis is made for the level of increase in the concentration of triglycerides. Prerequisites for when CRP in the blood is elevated:

• with diseases of the joints;
• with diseases of the bones;
• postoperative complications;
• with infectious diseases;
• acute myocardial infarction;
• cardiovascular complications after coronary bypass surgery;
• tissue damage during burns, injuries, both external and internal;
• in patients with atherosclerosis;
• with collagenosis;
• in patients with hypertension (arterial hypertension);
• in those on hemodialysis;
• in patients with diabetes;
• in violation of protein metabolism (amyloidosis);
• with atherogenic dyslipidemia;
• after biochemistry;
• disease gastrointestinal tract;
• excess body weight in violation of hormonal balance;
• infection after surgery.

CRP negative - what does it mean

During the decoding of the result of the blood test, there may be a value: CRP is negative. This only means that no inflammatory processes requiring active therapeutic measures occur in the body. When the reference value does not contain numbers, but only a “-” minus sign, then there is no reason to worry, and the CRP value is normal.

CRP positive

By analogy with the minus sign, the CRP value may be positive. Then you need to pay attention to the number of affixed "pluses". Their number varies from one to four. The more “+”, the stronger the inflammatory or other negative process in the body. The doctor who gives the interpretation of the analysis must quickly find the reason that influenced this result, when the C-reactive protein begins to actively increase.

C-reactive protein - an indicator of the inflammatory process, helps in the timely appointment of antibiotics.

Synonyms: C-reactive protein, CRP, CRP, CRP, CRP.

C-reactive protein is

Violation of the integrity of any tissue - be it a muscle or skin, leads to the launch of inflammation. Substances are released that stimulate the formation of C-reactive protein in the liver.

C-reactive protein attaches to the shell of the microorganism and makes it more "visible" to the immune system.

Adhesion of C-RP to the inner surface of the vessel destroys it and promotes the development.

The degree of increase in C-reactive protein corresponds to the volume and activity of the damage, but does not indicate its location in the body (C-RP will be increased both with and with a tooth abscess).

There are qualitative (expressed in pluses) and quantitative (in mg/l) methods for studying C-RP in the blood. Of course, quantitative analysis is better, because it will more accurately reflect changes in one direction or another. Distinguishing "+++" from "++++" is difficult, but 80 mg / l from 43 mg / l is much easier. And the difference is 2 (!) Times.

Indications

• identification of the inflammatory process
• differential diagnosis between bacterial and viral infections
• with fever, chronic pain in the joints, spine, muscles, back,
• before and after surgery
• 2-3 days after the start of treatment with antibiotics, anti-inflammatory, immunosuppressive drugs
• all acute diseases and conditions - acute thrombophlebitis, acute abdomen, coma
• chronic processes - autoimmune, rheumatic, tumor diseases

Norm

• 0-5 mg/l, in some laboratories up to 10 mg/l
• — up to 20 mg/l
• newborns - up to 15 mg / l
• infants - up to 10 mg / l
• chronic nicotinism (smoking) - up to 20 mg / l
• after physical activity(marathon) - up to 60 mg / l

Norm of C-reactive protein is not defined international standards therefore depends on the technique and reagents used in the laboratory. In the laboratory test form, the norm is written in the column - reference values.

Additional Research

• — ( , ), ( , )
• - , and
• -, low density lipoproteins, high density lipoproteins,
• , cerebrospinal fluid, pus
• C3 and C4 complement components

What influences the result?

• age, low and excessive physical activity, obesity, high-protein diet (in athletes), depression and sleep disturbances increase C-reactive protein
• with elevated triglycerides, insulin and C-peptide, CRP is also elevated
• with high rheumatoid factor, CRP is falsely elevated

Decryption

Reasons for the increase

1. infectious diseases

• bacterial inflammation ( , ) - CRP rises to 100 mg / l
• severe generalized bacterial infections and sepsis (bacteria circulate to and can spread to other organs) - CRP 200-300 mg/l
• viral infections - half do not have an increase in CRP, if there is an increase, then it is rather weak up to 50 mg / l, so bacterial pneumonia can be distinguished from viral
• congenital infections caused by bacteria (C-RP in umbilical blood 10-20 mg/l), with sepsis and CRP above 50 mg/l
• bacterial meningitis - CRP above 100 mg / l, tuberculous meningitis - 20-60 mg / l, viral - below 20 mg / l, often normal

2. connective tissue diseases

• - an autoimmune inflammatory disease of the small joints of the hands, the degree of increase in C-RP reflects the severity of the disease
• - inflammation as a result of infection with a streptococcal bacterium, if antibiotics are not prescribed in time, an incorrect immune response develops against the microbe and its own tissues
• - chronic muscle pain
• juvenile chronic arthritis - inflammation of the joints in children under 16 years of age
• psoriatic arthritis
• Reiter's syndrome - non-purulent inflammation of the joints, urethritis (inflammation of the urethra) and conjunctivitis; after intestinal inflammation, caused by chlamydial infection
• inflammation fallopian tubes, inflammation of the ovaries, inflammation of the membranes during pregnancy

Result interpretation

• a slight increase in C-RP — a risk factor for atherosclerosis; the higher the chronically high C-RP, the higher the risk of myocardial infarction
• highly sensitive C-reactive protein assay is used to assess the risk of cardiovascular disease
• CRP above 100 mg/l - bacterial infection; at right choice antibiotic C-RP decreases rapidly, if incorrectly - remains at the previous level
• when choosing the optimal drug and its dose in the treatment of rheumatic diseases
• C-RP 10-50 mg/l - local bacterial infection ( , ), after surgery or trauma (laparoscopy or ankle dislocation), myocardial infarction, deep vein thrombosis lower extremities, remission in rheumatological diseases, neoplastic diseases, most viral infections
• C-RP up to 100 mg / l - an indicator of more severe inflammation and the highest severity
• CRP above 100 mg/l indicates a severe bacterial infection

Data

• half-life 24 hours
• CRP has a high rate of both increase and decrease, but ESR - after a sharp rise, the return to normal occurs after CRP
• the C-reactive protein gene is located on the 1st chromosome
• highly sensitive CRP better indicator of atherosclerosis than lipidogram data
• formerly used as one of the markers of myocardial infarction

C-reactive protein was last modified: March 30th, 2018 by Maria Bodyan