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2007, Cilt 5, Sayı 1, Sayfa(lar) 027-032
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Are We Using High Sensitivity C-reactive Protein Rationally ?
Özben Özden Işıklar1, Güneş Başol2, Burcu Barutçuoğlu2, Erkin Bozdemir2, Ceyda Kabaroğlu2, Zuhal Parıldar2, Işıl Mutaf2, Dilek Özmen2
1Ege Üniversitesi Tıp Fakültesi, Biyokimya Anabilim Dalı, İzmir
2Ege Üniversitesi Tıp Fakültesi, Klinik Biyokimya Bilim Dalı, İzmir
Keywords: C-reactive protein, high sensitivity C-reactive protein, cardiovascular risk

Objective: After proving that chronic low grade inflammation is an important component of atherosclerotic process, C-reactive protein (CRP) has been started to be used for atherosclerotic vascular disease risk determination together with the other risk factors. In practice, to determine the prognosis of atherosclerotic vascular disease, CRP also is aplicable. For vascular purposes, determination limit less than 0.3 mg/L high sensitivity CRP assays are developed. These methods are much more expensive than conventioanal non-high sensitivity methods and should not be preferred for levels detectable with conventional CRP. The aim of this retrospective study is to determine the application of hs-CRP at an effective measuring range and to investigate economic side of hs-CRP usage.

Material and Methods: Between 2003 and 2006 hs-CRP results were investigated. At this time period, according to detection limits of CRP, hs-CRP results distribution was designated.

Results: In four years, 5927 / 8673 (68.34%) patients had hs-CRP less than 5 mg/L and 2746 / 5927 (31.66%) had hs-CRP greater than 5 mg /L. There were no significant difference of these percentages between four years (p>0.050). In the second half of 2006, for patients CRP detection limit greater than 1 mg/L, hs-CRP measuring was 75.53 %. Number of test requests throughout four years gradually increased (1024, 1246, 2796,3607 tests, respectively).

Conclusion: According to the recent budget implementing directives, the price of a single test of hs-CRP is ten times greater than CRP (budget implementing directives; turbidimetric CRP versus micro CRP), and this study conveys a big economical lost due to the physician's request of high sensitive CRP although the sample concentration could be measured with methods that are not high sensitive. Measuring the concentration with a non-sensitive method first, and then if needed switching to a high sensitive method would be more rational and economical. Increasing most of the non high sensitivity methods' sensitivity by enabling them to be capable of detecting 1 mg/L as a concentration strengths our two step approach.


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