糖尿病与发炎指标CRP..pptVIP免费

糖尿病與發炎指標CRP吳達仁醫師成大醫學院附設醫院內科部內分泌新陳代謝科CRP:FromAcutePhaseProteintoCRP:FromAcutePhaseProteintoCardiovasculardiseaseCardiovasculardisease•CRPisasymmetricalringmoleculethatconsistsof5noncovalentbutassociateprotomers.Eachprotomerhas2calciumionsresponsibleforthespecificbindingofphosphochlorine.Phosphochlorineisacommonconstituentofmanybacterialandfungalpolysaccharidesandmostbiologiccellmembranes,suchasthephosphochlorineresiduesofC(orcapsular)-polysaccharideofStreptococcuspneumoniae.Theproteinwasnamed“C-reactive”becauseofthisreaction.•Astablepentamericprotein-compoundwithahalf-lifeof19hours,withoutdiurnalvariation,•CRPisapathogenicmarkerandanonspecificmarkerofinflammation.CRPissynthesizedinresponsetotheacutephaseofabacterialorfungalinfection.MolecularStructureandMorphologyofHumanCRPMolecularStructureandMorphologyofHumanCRP(a)Negativelystainedelectronmicrographshowingthetypicalpentamericdisc-likestructureface-onandside-on(arrows).(b)Ribbondiagramofthecrystalstructure,showingthelectinfoldandthetwocalciumatoms(spheres)intheligand-bindingsiteofeachprotomer.(c)Space-fillingmodeloftheCRPmolecule,showingasinglephosphocholinemoleculelocatedintheligand-bindingsiteofeachprotomer).PepysMB,etal.ClinInvest2003;111:1805-1812.AssaysofCRPandReferenceRangesAssaysofCRPandReferenceRangesDuringtheacutephaseofinfection,serumCRPlevelsweremeasuredbyratenephelometry(“serumCRPassay”).Theseassayshavealowerlimitofdetectionofonly6to10mg/l.Amoresensitivelatexparticle-enhancedimmunoturbidimetricassay(“highsensitivity[hs]-CRPassay”)hasbeendevelopedthathasalowerlimitofdetection(orsensitivity)ofabout0.15mg/l.Itisusedtoassessforcardiovascularrisk.Theriskfactorsbyhs-CRPlevels(CDC,AHA):•CRP1mg/lislowCVDrisk•CRP1to3mg/lismoderateCVDrisk•CRP3to10mg/lishighCVDrisk•CRPlevels10mg/lgenerallyindicatesbacterialinfectionDemographicandDescriptiveCharacteristicsoftheDemographicandDescriptiveCharacteristicsoftheUSPopulationWithoutaPreviousDiagnosisofUSPopulationWit...