C-reactive protein in the blood: elevated, normal, causes

C-reactive protein (CRP, C-Reactives protein - CRP) is a fairly old laboratory test, which, like ESR, shows that an acute inflammatory process is going on in the body.

It is not possible to detect CRP by conventional methods; in a biochemical blood test, an increase in its concentration is manifested by an increase in α-globulins, which it, along with other acute phase proteins, represents. The main reason for the appearance and increase in the concentration of C-reactive protein is acute inflammatory diseases, which give a multiple (up to 100 times) increase in this acute phase protein after 6 - 12 hours from the start of the process.

In addition to the high sensitivity of CRP to various events occurring in the body, for better or worse, it responds well to therapeutic measures, therefore, it can be used to control the course and treatment of various pathological conditions, accompanied by an increase in this indicator.

What it is?

C-reactive protein is a two-component molecule consisting of proteins (peptides) covalently linked to several oligosaccharides. The name is due to its ability to interact with the C-polysaccharides of bacteria of the Streptococcaceae family, while forming a stable antigen-antibody complex (precipitation reaction). This mechanism relates to the protective reactions of the human body to infectious infection.

With the penetration of the pathogen, the immune system is activated, which stimulates the synthesis of small peptide molecules - cytokines. They provide a signal for the manifestation of the inflammatory process and the need to enhance the production of acute phase proteins, which are CRP. After 1-2 days, there is an increase in CRP by tens and hundreds of times compared with normal values.

It was noted that the maximum level of CRP (more than 150 mg / ml) is recorded in infectious diseases of bacterial etiology. While with viral infection, the protein concentration does not exceed 30 mg / L. Tissue death (necrosis) is another reason for the increase in c-reactive protein, including heart infarction, malignant neoplasms and atherosclerosis (excessive blood cholesterol deposition in blood vessels).

Norm CRP

In the blood of a healthy person, the level of CRP is very low or this protein is completely absent (in a laboratory study, but this does not mean that it is not at all - just the test does not catch scanty amounts).

The following limits of values ​​are accepted as normal, and they do not depend on age and gender: in children, men and women, it is one - up to 5 mg / l, the exception is only for newborn children - they are allowed to have up to 15 mg / l of this acute-phase protein (as evidenced by reference books). However, the situation changes with the suspicion of sepsis: neonatologists begin urgent measures (antibiotic therapy) with an increase in CRP in a child to 12 mg / l, while doctors note that a bacterial infection in the first days of life may not give a sharp increase in this protein.

A laboratory study is prescribed to detect C-Reactives protein, in the case of many pathological conditions accompanied by inflammation, the cause of which was an infection or destruction of the normal structure (destruction) of tissues:

  1. The acute period of various inflammatory processes,
  2. Activation of chronic inflammatory diseases,
  3. Infections of viral and bacterial origin,
  4. Allergic reactions of the body,
  5. Active phase of rheumatism,
  6. Myocardial infarction.

In order to better understand the diagnostic value of this analysis, it is necessary to understand what the acute phase proteins are, to find out about the causes of their appearance in the patient’s blood, and to examine in more detail the mechanism of immunological reactions in the acute inflammatory process. What we will try to do in the next section.

What is CRP

C-reactive protein (abbreviated as CRP) is a complex compound of carbohydrates and proteins that is produced in the liver cells. In the blood of a healthy person, its content is so low that most devices can even show a zero result. The production of this substance is stimulated by any factors that pose a threat to the body. These include:

  • Harmful bacteria
  • Any viruses
  • Pathogenic mushrooms,
  • Injuries, including surgery,
  • Damage to internal organs (heart attacks, strokes, rupture of tissues, etc.),
  • Tumors and metastatic growth,
  • Autoimmune reactions are immune disorders in which blood cells begin to produce substances that damage healthy tissues.

High C-reactive protein activates the body's defense systems. It is an important component of the immune system, which activates the release of antimicrobial and antiviral substances, and also stimulates the work of defensive cells.

A side effect of protein is its effect on fat metabolism. In high concentrations, this compound contributes to the deposition of "bad cholesterol" (low density lipoproteins - LDL) in the artery wall. That is why the measurement of this indicator is used in assessing the risk of vascular complications.

Comparison with ESR

In addition to the C-reactive protein, a marker of acute inflammation in the body also shows ESR (erythrocyte sedimentation rate). They are united by the fact that both indicators increase with a number of diseases. What is their difference:

  • CRP increases much earlier and decreases faster. Therefore, in the early stages of diagnosis, it is more informative than ESR.
  • If the treatment is effective, then c-react. protein decreases by 7-10 days, and ESR decreases only after 14-28 days.
  • The results of ESR are affected by the time of day, the composition of the plasma, the number of red blood cells, gender (higher in women), the results of CRP are not dependent on these factors.

It becomes clear that the analysis of C reactive protein is a more sensitive method for assessing inflammation than ESR. If a disease is suspected, to establish the cause, determine the acute process or chronic, assess the activity of inflammation and the effectiveness of the therapy, it is more informative and convenient.

Reasons for the increase

There are 3 main groups of reasons that can lead to an increase in the content of CRP in the blood - the inflammatory process, oncology and arterial vascular pathology. They include a huge number of diseases, between which it is necessary to conduct a diagnostic search. The degree of protein increase helps to navigate approximately pathologies:

  • More than 100 mg / l - such a strong immune reaction is most often observed with bacterial infections (microbial pneumonia, salmonellosis, shigellosis, pyelonephritis, etc.),
  • 20-50 mg / l - this level is more characteristic of human viral diseases, such as mononucleosis, adenovirus or rotavirus infection, herpes and others,
  • Less than 19 mg / l - a slight excess of the normal value can be for any significant factor affecting the body. However, with constantly elevated CRP, autoimmune and oncological pathologies should be excluded.

But, the level of CRP is a very approximate indicator, and even the above boundaries are quite arbitrary. It happens that in a patient with rheumatoid arthritis, CRP is above 100, during an exacerbation. Or in a septic patient 5-6 mg / l.

At the beginning of the inflammatory process, literally in the first hours, the protein concentration will increase, and may be more than 100 mg / l, after 24 hours there will already be a maximum concentration.

Under what conditions and diseases increases:

  • After heavy surgery
  • After injuries, burns
  • After transplantation, if CRP increases, it indicates transplant rejection
  • With tuberculosis
  • With peritonitis
  • With rheumatism
  • Endocarditis, myocardial infarction
  • Oncological diseases with metastases
  • Acute infections - fungal, viral, bacterial
  • With helminthiases
  • Multiple melanoma
  • With various autoimmune diseases
  • Severe allergic reactions

What is C-reactive protein for?

This peptide refers to the proteins of the "acute phase". And this means that CRP is one of the first to be synthesized in the liver in response to tissue damage and performs such functions:

  • activates immune responses
  • promotes phagocytosis,
  • increases white blood cell motility,
  • enhances the functional activity of T-lymphocytes,
  • binds to bacterial C-polysaccharides and phospholipids of damaged tissues.

In fact, he is actively involved in immune defense. Its concentration in the blood increases significantly during the first days after the onset of inflammation, and decreases with recovery. It is produced in response to the appearance of bacteria polysaccharides in the body. It is precisely because of its ability to precipitate pneumococcal membranes with the C-polysaccharide that it got its name. In addition, CRP is synthesized if necrotic processes occur in the body, because it reacts to phospholipids of damaged tissues.

Increased CRP is an early sign:

Not only C-reactive protein is an indicator of acute inflammatory process. Indicates the same pathologies and ESR. Both of these indicators suddenly increase as soon as the disease arose, but they also have differences:

  • CRP appears much earlier, and then disappears faster than the ESR changes. That is, in the early stages of diagnosis, the identification of C-reactive protein is much more effective.
  • If therapy is effective, it can be determined by CRP on days 6-10 (its level will significantly decrease). The erythrocyte sedimentation rate decreases after 2-4 weeks.
  • CRP does not depend on gender, time of day, red blood cell count, plasma composition, and these factors have a significant effect on ESR.

That is why the level of CRP in the blood is an important diagnostic criterion in determining the cause of the disease. Determining its concentration is the most sensitive method for assessing the activity of chronic and acute inflammatory processes. He is examined with suspicion of various diseases, and by how much the level of CRP in the blood has increased, the specialist will make a timely and accurate diagnosis.

How informative for chronic diseases

For the diagnosis of chronic diseases, this analysis is uninformative. In diseases such as rheumatoid arthritis, systemic vasculitis, sponylarthropathy, myopathy, the result of the analysis depends on the activity of the process, and it is used to evaluate the effectiveness of therapy. The prognosis is unfavorable if the amount of protein does not decrease, but increases.

Examples of assessment of the analysis for specific diseases:

  • Myocardial infarction - in this condition, CRP increases after 20-30 hours. Then, from day 20 it begins to decline, and after 1.5 months it returns to normal. High levels of protein - poor prognosis and the likelihood of death. Repeated growth indicates relapse.
  • Rheumatoid arthritis - a protein is determined for both diagnosis and treatment control, but rheumatoid arthritis cannot be distinguished from arthritis.
  • With systemic lupus erythematosus, the level of analysis will be within normal limits if there is no serositis. An increase in its concentration may indicate the occurrence of arterial thrombosis.
  • Malignant tumors - not specific to oncology, also increases with relapse after treatment. Used in combination with other methods for evaluating the effectiveness of treatment (tumor markers).
  • Bacterial infections - here CRP indicators are much higher than with viral infections.
  • Angina pectoris - with stable angina pectoris, the indicators are most often normal, and with unstable levels increase.
  • Ankylosing spondylitis - the amount of protein depends on the activity of the process.
  • Even a slight increase to 10 mg / L of C-reactive protein indicates a risk of thromboembolism, atherosclerosis, and myocardial infarction.

The patient’s condition, age and gender can alleviate the problem for the doctor. For example, young women have an extremely low risk of having atherosclerosis, and men 50-60 years old have little chance of contracting a childhood infection. The most characteristic causes of increased C-reactive protein for different population groups are discussed below.

Causes of Increased C-Reactive Protein

The laboratories use different methods of determination. Identify the concentration of CRP using:

  • radial immunodiffusion,
  • nephelometry
  • IFA.

If you take a blood test at different diagnostic centers, then the final numbers may vary slightly. That is why it is better to take the second test in the same laboratory as the first one.

adults absent (traces or not more than 5 mg / l) newborns less than 15 mg / l

If there is an inflammatory process, in the first hours of the disease, the concentration of this protein begins to increase. Its amount exceeds the norm by 100 times or more and is constantly growing. After a day, its maximum concentration is reached.

Its amount in the blood rises due to heavy operations. After transplantation, an increase in protein concentration indicates transplant rejection.

By examining the amount of CRP in the blood, the doctor determines the effectiveness of therapy. If its level is significantly increased, then the prognosis of the course of the disease is unfavorable. And he points to such diseases:

The feasibility of studying the level of C-reactive protein will be determined only by a doctor. Indeed, the diagnosis of diseases according to the elevated level of CRP has many features. For instance:

  • An increase in C-reactive protein is accompanied by rheumatoid arthritis. Determining the level of CRP is recommended not only for the diagnosis of this disease, but also for monitoring the effectiveness of treatment. However, for this indicator alone it is impossible to distinguish rheumatoid arthritis from rheumatoid polyarthritis.
  • The amount of CRP depends on the activity of ankylosing spondylitis.
  • With systemic lupus erythematosus (SLE), if there is no serositis, its level will be within normal limits.
  • In patients with SLE, an increase in the concentration of C-reactive protein indicates the development of arterial thrombosis.
  • Myocardial infarction is accompanied by an increase in CRP after 18-36 hours. Its level begins to decline from 18-20 days and after a month and a half, it returns to normal. With relapse, a surge in C-reactive protein occurs.
  • Often its level increases in patients with unstable angina. And with stable - this indicator is within normal limits.
  • The synthesis of CRP due to malignant tumors is increasing. And since this “acute phase” protein is nonspecific, it is studied in conjunction with other tumor markers for accurate diagnosis.
  • With a bacterial infection, the concentration of C-reactive protein is significantly higher than with diseases provoked by viruses.

CRP is intensively synthesized in the following chronic diseases:

  • rheumatoid arthritis,
  • spondyloarthropathy,
  • systemic vasculitis
  • idiopathic inflammatory myopathies.

In these diseases, the protein concentration depends on the activity of the process, therefore, the study of its amount is necessary to monitor the effectiveness of treatment. A steady increase indicates an unfavorable prognosis. And with myocardial infarction, the activity of C-reactive protein is associated with a high probability of death.

A number of scientific studies have shown that even a slight increase in CRP to 10 mg / l indicates a risk of:

But for the diagnosis of chronic diseases, C-reactive protein indicators are unreliable.In addition, its excessive amount is recorded in various autoimmune, infectious, allergic diseases, necrotic processes, after injuries, burns, and surgical operations. Therefore, the doctor will make an accurate diagnosis based on an increase in CRP in the blood by conducting additional examinations.

Indicator in women

In the absence of obvious symptoms and an increase in c-reactive protein in women, a thorough diagnostic search is necessary. This is especially true for the age group of 30-60 years. It was at this time that there was a significant increase in the incidence among the fair sex. First of all, the presence of the following pathologies should be excluded:

  • Gynecological diseases (endomentriosis, endometritis, true erosion of the cervix, cervicitis and others),
  • Oncology - it is precisely in women 40-60 years old that the onset of tumor growth often occurs, for example breast cancer or cervical cancer. In order to timely detect and treat them at an early stage, it is strongly recommended to undergo an annual examination by a gynecologist, starting from 35 years old,
  • The focus of chronic infection. CRP is an excellent indicator of a protracted inflammatory reaction. Despite the fact that they can not disturb a person (up to a certain time) and not reduce his quality of life, their presence is still reflected in the analysis of reactive protein in women.

What infections should be ruled out? In the first place, girls are affected by the urogenital tract: chronic pyelonephritis, cystitis, urethritis, infections with sexual transmission (chlamydia, mycoplasmosis, gardnerellosis, etc.). The following, in terms of frequency of occurrence, are pathologies of the digestive system - pancreatitis, chronic cholecystitis, intestinal dysbiosis and others.

The absence of these diseases against the background of increased CRP is an occasion to continue the diagnosis, in order to detect the pathology of other tissues / organs.

Symptoms and Diagnosis

Indirect symptoms indicate an increase in CRP levels:

  • temperature increase
  • mild chills
  • periodic cough and shortness of breath,
  • increased total sweating,
  • In the general blood test, an increase in ESR and the number of leukocytes is recorded.

More recently, a C-reactive protein assay has been prescribed to detect latent inflammatory processes. Today, it can be used to assess the risk of cardiovascular ailments in people who are practically healthy. First of all, this applies to elderly patients.

The main indications for the study are as follows:

  • the development of coronary heart disease and other ailments that unfold against the background of atherosclerosis.
  • timely fixation of exacerbations after surgical operations, such as bypass surgery or angioplasty.
  • identification of the risk of recurrent heart attack or stroke.
  • assessment of the effectiveness of treatment with antibacterial drugs of a bacterial infection.
  • period of treatment of cardiovascular diseases.
  • suspected presence of neoplasms.
  • the appearance of signs of lupus erythematosus.
  • diagnosis of Crohn's disease and ulcerative colitis.

To ensure the reliability of the results, the test is carried out in the morning. In addition, you should not eat 12 hours before the procedure, temporarily give up physical activity and avoid stress.

Having recorded an increased level of protein and excluding the effect on the indicator of subjective factors, the doctor determines with therapy.

The increase in men

Despite the fact that men are considered to be the stronger sex, their morbidity and mortality significantly exceed the similar indicators in women. In this case, acute infections are not a leading pathology in adults. A more serious problem is chronic diseases, which gradually damage various tissues and lead to depletion of the body's resources. Their diagnosis can be quite complicated, and often the first sign is an increase in C-reactive protein.

To facilitate the diagnostic search, it should be remembered which pathologies are most often found in middle-aged and older men. In the absence of obvious symptoms suggesting a specific diagnosis, these diseases are recommended to be excluded in the first place:

Genitourinary damage:

  • Urolithiasis (ICD),
  • Glomerulonephritis,
  • Prostatitis,
  • Sexually transmitted infections (chlamydia, mycoplasma / ureaplasma infection, gardnerellosis, etc.)
  • Burdened heredity (only for ICD and glomerulonephritis),
  • Intermittent sexual intercourse,
  • Congenital malformations of the urinary tract (omission of the kidney, improper position of the ureters, abnormal connection of the ureters and bladder).
  • General and bacteriological analysis of urine,
  • Microflora smear test
  • Excretory urography,
  • Ultrasound of the urinary system.
  • Burdened heredity is an extremely important factor, especially if close relatives suffered from cancer / sarcoma at a young age,
  • Work with radiation (flaw detector, service on nuclear submarines, work at nuclear power plants, etc.),
  • Any chronic inflammatory reaction that has not been adequately treated,
  • Smoking and alcoholism,
  • Contact with carcinogens (work in hazardous industries and living in an environmentally disadvantaged area).
Diagnosis depends on the location of the tumor. To establish a diagnosis, computed tomography and biopsy (taking part of the tumor) are almost always used.

An increase in C-reactive protein in oncology is often almost the only manifestation of pathology. This should be remembered so as not to miss a person with this dangerous diagnosis and timely diagnosis and necessary treatment measures.

What is c-reactive protein, and how much should the norm be?

C-reactive protein is a two-component molecule consisting of proteins (peptides) covalently linked to several oligosaccharides. The name is due to its ability to interact with the C-polysaccharides of bacteria of the Streptococcaceae family, while forming a stable antigen-antibody complex (precipitation reaction). This mechanism relates to the protective reactions of the human body to infectious infection.

With the penetration of the pathogen, the immune system is activated, which stimulates the synthesis of small peptide molecules - cytokines. They provide a signal for the manifestation of the inflammatory process and the need to enhance the production of acute phase proteins, which are CRP. After 1-2 days, there is an increase in CRP by tens and hundreds of times compared with normal values.

It was noted that the maximum level of CRP (more than 150 mg / ml) is recorded in infectious diseases of bacterial etiology. While with viral infection, the protein concentration does not exceed 30 mg / L. Tissue death (necrosis) is another reason for the increase in c-reactive protein, including heart infarction, malignant neoplasms and atherosclerosis (excessive blood cholesterol deposition in blood vessels).

Physiological function of CRP

CRP is classified as an acute phase protein in the inflammatory process, it takes an active part in:

  • the launch of the cascade of enzymatic reactions of the compliment system,
  • enhancing the process of monocyte production - white blood cells capable of implementing the process of phagocytosis of relatively large foreign particles,
  • stimulating the synthesis of adhesion molecules, which are necessary for the attachment of immunity cells to the surface of an infectious agent,
  • the process of binding and conversion of low density lipoproteins ("bad" cholesterol), the accumulation of which is indirectly increased the risk of developing CVS pathologies.

Thus, the importance of c-reactive protein for the human body is difficult to overestimate, since without it it is impossible to fully protect against foreign pathogenic microorganisms.

Blood test with reactive protein

Quantifying CRP quantitatively is a technique implemented in private and some public laboratories. The deadline, not counting the day of taking the biomaterial, does not exceed 1 day. However, obtaining results may be delayed due to the high workload of the laboratory.

The analysis is performed using the method of immunoturbidimetry, the essence of which is to determine the degree of turbidity of the solution in the presence or absence of the formation of a stable complex "antigen-antibody". The advantages of the method include low cost, a high degree of reliability and the possibility of obtaining quantitative results.

The technique is divided into analysis with a normal and increased degree of sensitivity. A highly sensitive blood test is necessary to diagnose the presence of not only an acute, but also a chronic inflammatory process in the blood vessels, as well as an early form of atherosclerosis. The minimum level of CRP detected by devices is 0.1 mg / L.

Signs of Elevated C-Reactive Protein

Symptoms of elevated CRP correspond to the clinical picture of the disease that caused this pathological condition. Patients often experience a sharp increase in body temperature (fever), joint pain, nausea and vomiting, as well as a general state of weakness and increased drowsiness.

Oncology can occur for a long time without the manifestation of typical signs. The classical clinical picture can develop in stages 3-4 of the cancer, when a malignant neoplasm leads to tissue necrosis and the spread of metastases.

The danger of atherosclerosis is a prolonged asymptomatic course. With this disease, the risk of myocardial infarction, which can lead to death, is significantly increased.

Therefore, it is extremely important to undergo an annual scheduled preventive examination, which includes a set of mandatory general clinical and biochemical analyzes, and often specific laboratory markers (if indicated).

Indications for the test

A test for c-reactive protein in the blood is prescribed for:

  • the need to identify inflammatory processes resulting from autoimmune pathologies or infectious infestations,
  • assessment of the effectiveness of the selected tactics for the treatment of infectious diseases,
  • differentiation of bacterial infection from viral,
  • determining the severity of an inflammatory or autoimmune disease,
  • postoperative monitoring and prevention of infectious complications,
  • deciding on the need for antibiotic therapy, as well as the duration of the course,
  • making a forecast, including lethal, against the background of pancreatic necrosis,
  • analysis of the extent and extent of damaged tissue with malignant neoplasms,
  • differentiation of some pathological conditions similar in symptoms and manifestations. For example: with granulomatous enteritis, c-reactive protein is increased, and with ulcerative colitis, it is reduced,
  • continuous monitoring of the activity of chronic pathologies.

A blood test for c-reactive protein in newborns is performed in case of suspected sepsis. It is characterized by infection by pathogenic microorganisms not of individual organs and tissues, but of the whole human body as a whole. The condition is life threatening.

Norm indicators for adults and children

Important: only the attending physician can decipher the blood test results obtained, determine the diagnosis and select treatment methods.

It should be noted that the use of CRP test in the examination of a patient is unacceptable.For a final diagnosis, data from other laboratory tests and instrumental diagnostic methods, as well as the patient’s history, are taken into account.

The norm of c-reactive protein in women and men varies depending on the degree of sensitivity of the method used and is presented in the table.

The degree of sensitivity of the methodNormal values, mg / l
Normal0 — 5
High0 – 1

It should be noted that the norm of c-reactive protein in children is similar to adults and should not exceed the indicated reference (normal) values.

The norm of reactive protein in women after 50 years also corresponds to standard values, while even a slight increase in reference indicators is a sufficient reason for a comprehensive examination.

CRP Risk Assessment

Important: in order to assess the risk of heart attack, the use of an exceptionally highly sensitive technique is permissible. A test with normal sensitivity does not allow you to determine the likelihood of developing a heart attack or other diseases of CVS.

A direct relationship was established between the level of CRP and the degree of risk of CVD pathologies, as well as their complications. So, normal values ​​not exceeding 1 mg / l are characteristic of a low probability of developing CVD diseases. The concentration of the considered laboratory criterion from 1 to 3 mg / l correlates with the average risk of developing atherosclerosis and, as a result, myocardial infarction. An increase in the value to 3 mg / l and more indicates a high probability of vascular and cardiac pathologies.

An increase in CRP to 10 mg / l or more is a good reason to conduct an additional examination in order to identify infectious diseases, viral or bacterial etiology.

It should be noted that, in comparative terms, patients with an increased level of CRP and normal indicators of “bad” cholesterol are characterized by a higher degree of risk of developing CVD pathologies than people with CRP within the normal range and high cholesterol.

If a person with coronary heart disease registers high values ​​of the considered criterion, then we can talk about the dangerous risk of recurrence of a heart attack or stroke, as well as the high likelihood of complications after coronary bypass surgery.

What does it mean if an adult has an increased c-reactive protein?

The reasons for the increase in c-reactive protein in a child and adult patients may be different, which allows the study to be classified as low-specific. The list of possible reasons:

  • acute form of infection by viruses (increase in the range of 10-30 g / l) or bacteria (from 40 to 100 mg / ml, and in severe cases of infection - up to 200 mg / l),
  • autoimmune pathologies (arthritis, vasculitis, polyarthritis),
  • some lymphadenopathies,
  • extensive damage to the integrity of tissues and organs: surgery, trauma, acute pancreatitis, pancreatic tissue necrosis, heart attack, stroke (up to 100 mg / l),
  • penetration of pathogenic microorganisms into the tissue of the heart valve,
  • cancer accompanied by the spread of metastases,
  • extensive burns and sepsis (more than 300 mg / l),
  • excessive production of female sex hormones (estrogen and progesterone). Which explains the increased CRP in the blood of women during pregnancy, as well as when taking oral contraceptives. However, it should be borne in mind that a significant deviation from the norm (2 or more times) indicates the development of the disease and requires immediate further examination.

It is noted that a slight excess of the norm is recorded in diabetes mellitus, increased blood pressure and in the presence of excess weight in humans.

Preparation for the delivery of biomaterial

The biomaterial for the test is venous blood serum taken by a specialist from the cubital vein on the elbow. More than 70% of errors are made at the preanalytical stage: at the stage of preparation of the patient and with improper implementation of the blood sampling procedure.Therefore, the reliability of the results obtained depends not only on the exact implementation of the test setup in the laboratory, but also on the proper preparation of the patient himself.

It is necessary to donate blood in the morning strictly on an empty stomach, the minimum time interval after the last meal should be 12 hours. In addition, half an hour before the delivery of the biomaterial, the patient is forbidden to smoke, as well as to experience physical and emotional strain. Sports training in the evening before the morning visit to the laboratory should also be canceled.

For 2 days, you should exclude the use of any medications, after consulting with your doctor. This rule is of particular importance for people who use the following medicines:

  • aspirin ®,
  • ibuprofen ®,
  • steroids,
  • lipid-lowering drugs,
  • beta blockers.

This fact is due to the ability of the above drugs to temporarily reduce the concentration of the laboratory criteria in question. Neglecting the rule can lead to false negative results, and, as a result, delaying the appointment of the necessary treatment.

It is extremely important to take a responsible approach to your health and be aware of the fact that the earlier a disease is detected, the easier it will be to cure and the more favorable the outcome prognosis for the patient himself.

Julia Martynovich (Peshkova)

Graduated, in 2014 she graduated with honors from the Federal State Budget Educational Institution of Higher Education at the Orenburg State University with a degree in microbiology. Graduate of postgraduate studies FSBEI HE Orenburg State Agrarian University.

In 2015 The Institute of Cellular and Intracellular Symbiosis of the Ural Branch of the Russian Academy of Sciences underwent further training under the additional professional program "Bacteriology".

Laureate of the All-Russian competition for the best scientific work in the nomination "Biological Sciences" of 2017.

Possible diseases

C-reactive protein will be increased already in the first 6-8 hours from the onset of the disease, and its values ​​will correspond to the severity of the process (the heavier the course, the higher CRP). Such properties of CRP allow it to be used as an indicator for the debut or course of various inflammatory and necrotic processes, which will be the reasons for the increase in the indicator:

  1. Bacterial and viral infections
  2. Acute cardiac pathology (myocardial infarction),
  3. Oncological diseases (including tumor metastasis),
  4. Chronic inflammatory processes localized in various organs,
  5. Surgical interventions (violation of tissue integrity),
  6. Injuries and burns
  7. Complications of the postoperative period,
  8. Gynecological pathology,
  9. Generalized infection, sepsis.

Elevated CRP often happens with:

It should be noted that the values ​​of the indicator for different groups of diseases can differ significantly, for example:

  1. Viral infection, tumor metastases, rheumatic diseases that occur sluggishly, without severe symptoms, give a moderate increase in CRP concentration - up to 30 mg / l,
  2. The exacerbation of chronic inflammatory processes, infections caused by the bacterial flora, surgical interventions, acute myocardial infarction can increase the level of acute phase marker by 20, or even 40 times, but in most cases, from such conditions, an increase in concentration to 40-100 mg / l can be expected ,
  3. Severe generalized infections, extensive burns, septic conditions can very unpleasantly surprise clinicians with numbers indicating the content of C-reactive protein, they can reach exorbitant values ​​(300 mg / l and much higher).

It is also worth mentioning a very important issue regarding the increased amount of CRP in healthy people. A high concentration of C-reactive protein with external complete well-being and the absence of signs of at least some pathology suggests the development of an oncological process. Such patients should undergo a thorough examination.

Reasons for Men

In the absence of obvious symptoms suggesting a specific diagnosis, these diseases are recommended to be excluded in the first place:

  1. Tumors
  2. GERD,
  3. Gastritis,
  4. Duodenal ulcer / stomach ulcer,
  5. Pancreatitis
  6. Cholecystitis,
  7. Crohn's disease,
  8. Ulcerative colitis.
  9. Urolithiasis (ICD),
  10. Glomerulonephritis,
  11. Prostatitis,
  12. Sexually transmitted infections (chlamydia, mycoplasma / ureaplasma infection, gardnerellosis, etc.)
  13. Chronic lung lesions of an obstructive nature (chronic bronchitis, emphysema),
  14. Occupational diseases (silicosis, pneumoconiosis, silicotuberculosis and others).

To facilitate the diagnostic search, you should ask your doctor what pathologies are most common in middle-aged and older men.

What is c-reactive protein and what are its functions

C-reactive protein (CRP, CRP) is an acute phase glycoprotein that appears in the human body within 4-6 hours after ingestion of a foreign agent that will cause the inflammatory process of any localization.

This is the most accurate diagnostic indicator of the onset of the pathological process. An increased level of CRP is observed at the stage when all other indicators (including ESR, which is considered a recognized marker of inflammation) are still within normal limits.

Previously, in the middle of the last century, tests for the detection of this protein were carried out by fairly simple methods that made it possible to assess the quality state.

That is, the results looked something like this:

  • positive c-reactive protein - there is an inflammatory reaction,
  • negative c-reactive protein - no pathology.

Modern diagnostic laboratory methods make it possible to determine the amount of this glycoprotein in blood serum with an accuracy of 5 mg / l. This is the minimum possible value, which does not indicate pathology.

To find out what are the functions of c-reactive protein in the blood, you need to understand the mechanisms of triggering the inflammatory process:

  1. When a foreign agent enters the body or damage the integrity of the skin, epithelial, muscle, nerve tissue, inflammation begins, characterized by the release of interleukins. This is part of the immune system that white blood cells produce. Thus, liver stimulation begins to produce c-reactive protein.
  2. CRP "marks" the cells of pathological microorganisms, attaching to their surface. This becomes a signal for the immune system and a sign of the site of the invasion.
  3. An increase in CRP triggers sequential responses of the immune response.
  4. At the very site of inflammation, pathogens decompose, with which the protein binds, and thereby contribute to the activation of phagocytosis.

If an increase in c-reactive protein in the blood is noticed, this means the presence of an inflammatory process of any localization. If CRP is increased against the background of the norm of all other indicators, specialists may suspect malignant processes. Then additional studies are appointed to refute or confirm the diagnosis.

You do not need to panic with an uncertain etiology of increased serum glycoprotein. There are cases when latent inflammatory processes occur in the body that indicate the presence of chronic diseases. Treatment will begin with an accurate diagnosis and the appointment of adequate therapy for the underlying ailment.

Reasons for women

First of all, the presence of the following pathologies should be excluded:

  1. Oncology - it is precisely in women 40-60 years old that the onset of tumor growth often occurs, for example breast cancer or cervical cancer. In order to detect them in a timely manner and conduct treatment at an early stage, it is strongly recommended to undergo an annual examination by a gynecologist, starting at age 35.
  2. The focus of chronic infection. CRP is an excellent indicator of a protracted inflammatory reaction.Despite the fact that they can not disturb a person (up to a certain time) and not reduce his quality of life, their presence is still reflected in the analysis of reactive protein in women.
  3. Gynecological diseases (endometriosis, endometritis, true cervical erosion, cervicitis and others).

In the first place, girls are affected by the urinary tract: chronic pyelonephritis, cystitis, urethritis, infections with sexual transmission (chlamydia, mycoplasmosis, gardnerellosis, etc.). The following, in frequency, are pathologies of the digestive system - pancreatitis, chronic cholecystitis, intestinal dysbiosis and others.

Causes in children

There are a large number of diseases caused by microorganisms, but in children the most common lesions of the digestive tract and respiratory tract.

They can occur acutely with the appearance of pronounced symptoms (dysentery, salmonellosis, pneumonia, acute respiratory viral infections and others) or slowly develop in the body, causing a chronic disease.

Thus, bronchitis, tonsillitis, sinusitis, gastritis, etc. can occur.

In second place, among the causes of increased C-reactive protein in children, are parasitic pathologies. Since at a young age the child’s hygiene is still being formed, the risks of introducing the parasite into the body are significantly increased. In Russia, the following types of these microorganisms are most common:

  • Ascaris
  • Pinworm,
  • Giardia
  • Opisthorch,
  • Wide ribbon
  • Bull and pork tapeworm.

Only after the exclusion of the listed pathologies, one should look for other factors in the child's body that can increase the concentration of CRP. Of course, this stage can be skipped if there are characteristic symptoms or examination results confirming a different diagnosis.

What to do and how to treat elevated C-reactive protein?

An increased 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. What it can be connected with can only be determined on the basis of additional research.

It is noteworthy that if therapy is chosen correctly, the level of C-reactive protein decreases rapidly and returns to normal.

For example, with the correct use of antibacterial drugs, a positive result is noted by a decrease in the level of CRP within a 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 an oncologist consultation is required.

In order for any prescribed therapy to be effective, you must follow the rules of a healthy diet and do not forget about moderate physical activity. In addition, you need to try to eradicate existing bad habits. Such standard rules will help to quickly restore and maintain health for many years.

Reasons for the growth of indicators

Various factors can cause a rise in c-reactive protein.

First of all, it is worth considering subjective, which directly depend on the person’s way of life and can be adjusted without the help of medications:

  • excessive and regular exercise. The level of CRP in athletes is always outside the norm, which until a certain point does not pose a threat to health - a prolonged increase in this indicator can provoke pathological conditions of an autoimmune nature,
  • oral and hormonal contraceptives taken for a long time,
  • significant weight that does not comply with the human constitution and age standards. Obesity as a result of metabolic disorders in the body,
  • protein-rich diet. This is especially true for people professionally involved in sports, bodybuilding and bodybuilding,
  • exposure to stress, unstable psycho-emotional state leading to the development of depression, sleep disturbance,
  • smoking.

Each person can either minimize or completely exclude the impact of these risk factors from his life.

But there are a number of pathological conditions that are causes of an increase in c-reactive protein and arise regardless of our desire or ability:

  • Bacterial infections cause CRP to increase 100 or more times, and in a very short period of time - no more than 1-4 hours from the time of infection.
  • Viral infections cause an increase in indicators slightly, although quite pronounced.
  • Fungal infections, as a rule, do not give a high rate, although it exceeds the norm by several tens of units - in the acute course of the disease.
  • Autoimmune disorders that cause chronic systemic diseases, such as rheumatoid arthritis, or ulcerative colitis, Crohn's disease or systemic vasculitis, and some other pathologies. The higher the concentration of this protein, the more severe the course of the disease.
  • Pre-infarction conditions and heart attacks, when the myocardium becomes inflamed, and with heart attacks, tissue necrosis and scarring begins. A blood test for the concentration of CRP in cores and hypertensive patients makes it possible to predict the course of an already existing pathology or to predict the degree of risk of its occurrence.

  • Acute inflammation of the tissues of internal organs with possible necrosis. A significantly increased indicator indicates the presence of serious problems, sometimes requiring surgical intervention.
  • Damage to the skin and muscle tissue from injuries and burns of varying degrees and localization. Even slight damage to tissue integrity will cause an increase in CRP.
  • After surgery. It is considered normal if c-reactive protein is elevated immediately after surgery. It begins to decline very quickly with a favorable outcome and the absence of complications. If the indicator not only does not fall, but also begins to increase, this is a bad sign, and when transplanting organs, it indicates rejection.
  • Malignant neoplasms of any organ and system of the human body. Moreover, this may be one pathological indicator against the background of the norm for the rest.
  • Diabetes mellitus and sugar.
  • Hypertonic disease.
  • During pregnancy, an increase in protein levels may indicate a risk of miscarriage or premature birth.

It should also be remembered that some medications can distort the results of tests and underestimate the level of CRP. These are anti-inflammatory non-steroid drugs and glucocorticoids.

Symptoms of elevated CRP and indications for analysis

Each adult can easily feel the symptoms when the reactive protein in the blood is elevated, but does not always attribute these symptoms to this indicator. They are not specific, but if you experience this kind of discomfort, it’s still worthwhile to determine its causes.

  • an increase in body temperature to subfebrile indicators, which is especially noticeable in the evening hours,
  • feeling of chills, accompanied by a feeling of "hot skin",
  • situational cough and cause dyspnea,
  • increased sweating - "throws it into cold, then into hot sweat." This feeling is familiar to women in menopause,
  • general blood count shows increased ESR and leukocytosis.

For diagnostic tests that show the level of c-reactive protein in the blood serum, there are certain indications.

  • atherosclerosis - to assess the development and treatment of ischemia and other cardiac pathologies,
  • tracking the results of operations to timely identify complications,
  • determination of the risk of recurring heart attacks or strokes, especially with hypertension,
  • evaluation of the effectiveness of the treatment of infectious diseases, cardiovascular pathologies,
  • if there is a suspicion of the presence of tumor processes of various localization,
  • to confirm the diagnosis of Crohn’s disease or ulcerative colitis.

C-reactive protein: normal, reasons for the increase

“Golden marker” - this is what clinicians call C-reactive protein for its ability to detect the acute phase of the inflammatory process. To the delight of the same clinicians, the test results can now be obtained in half an hour (in some cases in an hour) instead of a day in connection with the introduction of modern techniques. At such a speed of processing a blood test, in addition to diagnosing a disease, it is possible to monitor the treatment process.

CRP and osteoporosis

Until now, doctors continue to study what this analysis shows, in addition to inflammation and cardiovascular risk. Recent studies have proven the relationship of C-protein with depletion of calcium reserves and bone tissue pathologies, i.e. osteoporosis. Why does this condition arise, and how is it dangerous?

The fact is that a large number of enzymes and trace elements, including calcium ions, are spent on maintaining the inflammatory process. If it proceeds long enough, the amount of these substances in the blood becomes insufficient. In this case, they begin to come from the depot. For calcium, bones are such a depot.

A decrease in its concentration in bone tissue leads to its increased fragility. A person with osteoporosis even needs a small injury to have a complete fracture or a “crack in the bone” (incomplete fracture).

At the moment, doctors have not determined the exact border of CRP, which increases the risk of bone changes. However, scientists at the NIIR RAMS found that prolonged exceeding the norm of this analysis is a serious risk factor for depletion of calcium reserves.

What does total protein concentration mean?

Proteins, or proteins, are constantly present in the blood and are carried throughout the body. Thanks to them:

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  • coagulation reactions are triggered,
  • metabolism takes place and is regulated,
  • transported nutrients and nutrients,
  • a stable volume of the bloodstream is maintained,
  • immune mechanisms work
  • blood elements are in suspension and do not stick together.

The constancy of the protein index is the key to homeostasis in the body - stable blood properties and the continuity of metabolic processes in tissues, the connection between all organs and systems. Protein levels can be measured in plasma or serum. The first is a liquid fraction of blood, purified from uniform elements. Serum is called plasma purified from fibrinogen protein. Because of it, the value of the total blood protein rises by 2-4 g / l.

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Serum proteins are conventionally divided into 2 types. The first group - albumin makes up about 55%. These proteins are produced primarily in the liver. They provide transport of pigments, hormones, vitamins, pharmacologically active substances. Albumin prevents the sweating of the liquid part of the blood through the vascular walls in the tissue. With a change in their concentration, the development of edema is possible.

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The second group is globulins. These substances include enzymes, antibodies, and other substances (about 500 species in total). Thanks to them, nutrients are distributed throughout the body.

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What is C-reactive protein

CRP (CRP - abbreviation from the English. C-Reactives protein) is a protein that is found in blood plasma and is formed in the liver. It belongs to the indicators of the acute phase of inflammation.

The synthesis of C-reactive protein is activated during the development of the inflammatory process of any localization in the human body.

The main mechanism of action of this marker is the precipitation reaction with the C-polysaccharide of pneumococci and other bacteria and fungi at the very early stages of the pathological condition.

The main characteristics of CRP are:

  • Higher sensitivity to inflammation as opposed to ESR - erythrocyte sedimentation rate.
  • Reacts after 4-6 hours after exposure to the pathogen or the development of a pathological condition (meaning non-infectious genesis).
  • Changes in indicators can be diagnosed already in the first day of the disease.

In the modern medical literature, evidence is presented that there are two varieties of C-reactive protein:

  • Native (pentameric, consists of 5 subunits) protein - this marker, which is known to everyone as directly CRP.
  • The new protein (monomeric, consists of 1 subunit) - is characterized by faster mobility, a decrease in platelet aggregation time, and the ability to activate and synthesize biological substances.

Monomeric protein antigens are located on the surface of lymphocytic and plasma cells, killer cells. In acute inflammation, the usual C-reactive protein is transformed into monomeric, which already has all the inherent effects of CRP.

For reference. In the body of a healthy and sick person, such an inflammatory trigger and its concentration are responsible for the most important functions of the immune system.

  • The most important duty of CRP is to participate in the implementation of humoral innate immunity. This effect is realized through complex sequential immune reactions, which provides a strong connection between innate and acquired immunity:
    • Destruction of the shells of healthy cells by a pathogen, other pathological factor. This leads to cell death. White blood cells, phagocytes migrate to such foci.
    • Now begins a local reaction to the disposal of dead cells, which causes an inflammatory reaction. In places of such reactions, first neutrophils accumulate, then monocytes, in order to absorb foreign elements, to contribute to the synthesis of mediators, with the help of which CRP begins to be intensively produced.
    • After this, the accelerated formation of all acute phase components begins.
    • At this stage, T-lymphocytes enter the reaction, which in response to macrophage delivery of antigens to the lymph nodes recognize antigenic structures and transmit information to B-lymphocytes. It is from this moment that the active formation of antibodies begins, which is a key link in humoral immunity. At all these stages, a C-reactive protein is involved in the reactions.
    • Within 10 to 12 hours, CRP levels in the blood are growing rapidly, which confirms its main functions - anti-inflammatory and protective.
  • It has properties, like immunoglobulin G, which is manifested by the ability to activate the complement system with platelet aggregation.
  • It causes erythrocyte hemolysis during inflammation, which are associated with pathological units.
  • In the focus of the infectious process, the effects of the decay products of pathogens are depressed.

Recommendation. Since the rate of reaction to antigens in CRP is quite high, then if some diseases are suspected, an analysis should be assigned to determine it as soon as possible.

To assess the severity of inflammation, it is necessary to perform a venous blood sampling on an empty stomach in the serum of which a C-reactive protein is determined during a biochemical study.

For reference. The main method for determining C-reactive protein is immunoturbodimetry, with the help of which even those values ​​are found whose concentration is below 0.5 mg / L.

It must be pointed out that a blood test to determine CRP is not mandatory for everyone. Such a test is carried out according to some indications.

Features of the analysis

C-reactive protein is not included in the biochemical analysis of blood at the present stage. A qualitative and semi-quantitative analysis is carried out, for which a special latex test based on latex agglutination is used.

Biological material is taken from a vein. The amount of blood is about 5 cubes.The result will be ready in a few hours, which is very important for the appointment of the correct and effective treatment, especially in the acute course of the disease.

Blood sampling is performed on an empty stomach in the morning and requires special preparation if this is a routine analysis.

  1. Do not eat for 6-8 hours before taking the test.
  2. Do not use any medications 12 hours before blood sampling, if it does not harm your health (if such medications are not vital and are taken regularly in the treatment of a chronic ailment).
  3. The day before the procedure, exclude fried, spicy, smoked and salty foods, as well as canned foods from the diet.
  4. For 2-3 days, do not drink even low alcohol drinks. It is advisable to refrain from simple carbonated drinks and mineral water.
  5. For at least 24 hours, do not engage in sports, do not perform physical exercises, and minimize physical activity.
  6. Try to minimize stressful situations and nervous strain all the time while preparing for the analysis.

If you use any medications, you should inform the laboratory assistant and your doctor who will deal with the decoding of the tests.

C-protein and pregnancy

Domestic and American scientists have long been interested in the relationship between pregnancy and this indicator. And after numerous studies, such a relationship has been discovered. If a woman does not have inflammatory diseases, protein levels can partially predict the course of pregnancy. Doctors discovered the following patterns:

  • With CRP levels above 7 mg / L, the likelihood of developing preeclampsia is more than 70%. This is a serious complication that occurs only in pregnant women, in which there is an increase in pressure, impaired renal filter, damage to the nervous and cardiovascular systems,
  • An increase in C-protein above 8.8 mg / L increases the risk of preterm birth,
  • In the case of an urgent birth (which occurred on time) and an increase of more than 6.3 mg / l, there is a high risk of the formation of chorioamnionitis. This is a bacterial complication that occurs when the amniotic fluid, membranes, or uterine endometrium are infected.

What does C-reactive protein mean in each case is quite difficult to determine. Since it can increase due to a large number of reasons, it is necessary to exclude all these factors before making a forecast for a pregnant woman. However, in the case of a correctly performed diagnosis, an obstetrician-gynecologist can plan the optimal tactics for managing his patient.

Indications for analysis

As for each marker, to determine the CRP are characterized by their own conditions, in which it is necessary to conduct research:

  • Assessment of the risk of pathology of the cardiovascular system in healthy and sick people.
  • If patients have coronary heart disease, arterial hypertension, the prognosis of complications such as sudden cardiac death, acute coronary syndrome, myocardial infarction, and stroke is assessed.
  • Evaluation of the extent of the zone of ischemia and necrosis in heart attack.
  • Analysis of the effectiveness of treatment.
  • Prevention of complications.
  • Diagnosis of acute infections.
  • Monitoring the development of the transplant versus host reaction.
  • Diagnosis of neoplasms.
  • Determination of complications in the postoperative period.
  • Monitoring the dynamics of diffuse connective tissue diseases and evaluating their treatment.
  • Differential diagnosis between viral and bacterial damage.
  • With complaints of prolonged pain in the joints, fever, pain in the back, muscles, as well as with an increase in lymph nodes.

When evaluating the data obtained, it is necessary to proceed from the norm values ​​for different categories of persons.

A bit about treatment

If reactive protein is elevated, the causes of this condition will indicate treatment. By itself, c-reactive protein is not treated - after all, this is only a clinical indicator of a certain ailment.It is he who needs to be treated so that all values ​​normalize.

The specialist will prescribe adequate therapy to help get rid of the disease.

But there are several standard rules that are designed to make any treatment as effective as possible:

  • if cholesterol is elevated, you need to find ways to lower it to normal levels,
  • physical activity should be within reason. It will help to keep weight under control,
  • Monitor your blood glucose
  • quit smoking and alcohol in excessive doses (if necessary - in general),
  • make the right diet.

Each person is free to choose his own way of existence: to burn his life in all conceivable and unthinkable ways, or to live reasonably and carefully, rejoicing at every moment of being. Health is the most important value along the way. Watch him.

Analysis preparation

To get the most reliable results of examinations, it is necessary to adhere to a number of recommendations before blood donation. For a child and an adult, the preparations for the analysis are no different, so the tips below are relevant for any age.

  1. It is optimal to donate blood in the morning - until 11:00. During the day, the level of hormones changes, a person undergoes mental and physical exercises. Therefore, when conducting the study at another time, the result may turn out to be false positive,
  2. 12 hours before the examination, you should not eat, drink alcohol and drinks containing caffeine (Coca-Cola, energy, coffee, strong tea). When passing the analysis in the afternoon / evening, let's say a light lunch 4 hours before the procedure,
  3. 3-4 hours before taking blood, it is not recommended to smoke, including electronic cigarettes,
  4. Immediately before the diagnosis, physical activity and stress should be excluded.

C-reactive protein norm

For the correct interpretation of the data obtained, the following factors must be taken into account:

  • Age.
  • The physiological state of man.
  • The presence of disease.

Norm. Currently, the following are considered normal indicators:

  • Adult men and women - no more than 10 mg / l.
  • Pregnant women - no more than 20 mg / l.
  • Newborns - the indicator should not exceed 15 mg / l
  • Children - up to 10 mg / l.
  • Smokers - concentration up to 20 mg / l.
  • Athletes, especially after severe physical exertion - no more than 60 mg / l.

In addition to taking into account the normal numbers of the test, it is necessary to take into account some reasons that can affect the analysis data.

Protein levels in the blood

The protocol of biochemical analysis indicates the concentrations of three types of protein - total, albumin, C-reactive. It is these species that are most significant in terms of a general assessment of the state of the body. Reference indicators depend on age. They are the same for representatives of different sexes.

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Table - Norms of total protein by age

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Population category

Physiological value, g / l

Newborns up to a month46‒68
Up to a year58‒73
Under 14 years old63‒82
The elderly60‒81

The second result usually indicates an indicator of albumin. The norms are also different for patients of different ages and are not dependent on gender.

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Table - Norms of the content of albumin in the blood

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Population category

Physiological value, g / l
Newborns up to a month35‒44
Up to a year35‒49
Under 14 years old35‒55

In children and adolescents under 14 years of age, C-reactive protein should not be detected. In this case, in the analysis indicate the word "negative" or put a dash. For adults, the presence of up to 0.5 mg / L is allowed.

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Protein concentration is studied using the biuret or microbiuret method. The method is based on the property of proteins to react with copper sulfate in an alkaline environment with the formation of insoluble complexes of purple color. The result is set according to the saturation of the hue of the resulting solution using a photometer.

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A biochemical blood test is prescribed for diagnostic purposes if a person has complaints of health or obvious signs of a developing disease. Doctors recommend taking the test once a year for preventive purposes. It is a change in the concentration of proteins that may indicate a beginning pathological process or the nucleation of a tumor.

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Exceeding the norm of this substance is not a direct cause of infertility, but may indicate its presence. Let me explain by example: in most cases, a girl cannot conceive a child because of an infectious lesion of the uterus, ovaries or fallopian tubes (respectively, endometritis, oofaritis, and salpingitis). In addition to other symptoms, with these diseases there is an increase in CRP.

No, in most cases it is not part of the diagnostic standard. Its level, as a rule, is assessed in cases of suspicion of an autoimmune reaction, liver damage, or with difficulties in diagnosing.

Doctors use the study not only to diagnose the disease, but also to measure its activity. This helps to clarify the condition of the person and adjust the treatment.

Yes, since these substances directly affect the liver and trigger the release of CRP.

Factors Affecting CRP

There are a number of circumstances in which the picture of the data obtained changes. That is why before passing the analysis, it is necessary to inform the attending physician about the reasons that may affect the outcome of the study:

  • The use of contraceptives.
  • Treatment with hormonal drugs.
  • Pregnancy.
  • Intense physical activity.
  • Age.

Since C-reactive protein is an indicator of the acute phase of inflammation and pathological disorders in the body, it is necessary to identify the source that caused the change in test levels.

Statins - C-Reactive Protein Reducing Drugs

Statins are medicines that lower blood cholesterol. They also have anti-inflammatory effects and lower C-reactive protein.

Many well-known cardiologists in English-speaking countries believe that statins reduce the risk of heart attack precisely because they fight inflammation.

And lowering blood cholesterol is a side effect of statins, which does not reduce mortality from cardiovascular diseases.

In order for the C-reactive protein in the blood to fall to normal, first of all, you need to use natural methods of slowing the development of atherosclerosis, which are described above. Statins are a second line of defense because they can cause side effects.

But if you have a high cardiovascular risk, then you need to take statins, in combination with a transition to a healthy lifestyle.

Patients at high risk are those with hypertension, obesity and diabetes, smokers, and especially people who have already had a heart attack or stroke.

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When C-reactive protein (CRP) rises

CRP immediately responds to any inflammatory and necrotic changes in the body. By the degree of protein increase, you can determine how serious the violations are. The indicator grows with:

By C-reactive protein, the formation of a cancerous tumor in the body can be suspected. The indicator changes at the earliest stages, when other blood characteristics still remain within normal limits, and any symptoms are absent.

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C-reactive protein after a heart attack

After myocardial infarction has occurred, the concentration of C-reactive protein in the blood often rises significantly. But this does not occur in all patients. Therefore, analysis for C-reactive protein is not suitable to distinguish myocardial infarction from an attack of angina pectoris.

Also, with the help of this analysis, it is impossible to determine the severity of a heart attack. At the same time, the higher the C-reactive protein score, the greater the likelihood that complications of acute coronary syndrome will occur.

Therefore, it is recommended to start taking statins already in the first hours after a heart attack, along with other medications to reduce inflammation.

When a patient with a heart attack enters the hospital, the doctors have a difficult question: how to treat it? Do I need to have an operation? Or can you limit yourself to prescribing medication without surgery? A blood test for C-reactive protein is not suitable to solve this. Use other methods.

However, the higher the C-reactive protein, the greater the likelihood of recurring heart attack and other complications. It is proved that the sooner the patient begins to take atorvastatin or rosuvastatin, the lower he will have C-reactive protein and the higher the chances of a favorable outcome. Statins after a heart attack are prescribed regardless of whether surgical treatment has been used or not.

In the first few days, high doses of these drugs are needed, and then they are lowered.

article "Rehabilitation after a heart attack".

Most people think that the risk of heart attack and stroke depends on blood cholesterol. In fact, the level of "good" and "bad" cholesterol is of little importance. Much more important is the result of a blood test for C-reactive protein, because cardiovascular diseases are inflammatory in nature.

You learned that the cause of myocardial infarction and stroke is chronic sluggish inflammation, not high cholesterol. This is essential information that can prolong your life. The site Centr-Zdorovja.Com brings it to a Russian-speaking audience.

Keep track of your blood test results for C-reactive protein, not just your “bad” and “good” cholesterol counts.

What are the symptoms

Hyperproteinemia is not always the result of pathological processes. The condition is not considered a disease. This is only a laboratory term that reflects violations of blood homeostasis. Elevated protein concentrations do not have their own symptoms. Manifestations are completely dependent on the underlying disease. It could be:

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  • fever,
  • subfebrile body temperature,
  • pain in the abdomen and other parts of the body,
  • heart rhythm disturbances
  • blood pressure differences
  • changes in appetite, digestive disorders, irregular stools,
  • rash on the skin and mucous membranes,
  • vomiting, nausea, diarrhea,
  • signs of dehydration (sagging skin, dry mucous membranes, tachycardia, low blood pressure, cramps),
  • general weakness, fatigue.

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With minor deviations from the norm, symptoms may not occur at all. In this case, changes in the biochemical parameters of the blood will be the first to indicate the development of the disease.

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Criteria for evaluation

Each disease is characterized by its own degree of increase in the indicators of the pathological process:

  • Sluggish infections, rheumatic diseases, which are characterized by a minimal presence of symptoms, as a rule, do not give an increase in CRP during the test more than 30 mg / l.
  • Exacerbations of chronic diseases, surgery, heart attack can give levels from 40 to 100 mg / L.
  • Severe infectious processes, burn disease, sepsis, severe forms of connective tissue diseases and autoimmune processes can show values ​​from 100 mg / l and much higher.

Attention. One of the most significant processes that are reflected in terms of C-reactive protein and risk assessment is taken into account - this is a pathology of the cardiovascular system.

Important. Due to the participation of C-reactive protein in the development of atherosclerosis and acute heart attack, this indicator is a highly sensitive marker for the prognosis and determination of cardiovascular catastrophes. Such conclusions are made by determining the ability to activate the complement system, the presence of low density lipoproteins and damaged, dead myocardial cells.

The study of CRP indicators in cardiology determines:

  • The risk of developing thrombosis with / without the development of stroke, heart attack.
  • Forecast after myocardial infarction.
  • The risk of developing fatal and non-fatal ischemia and cardiac muscle necrosis.
  • Marker of repeated stenosis after surgery due to the elimination of stenosis.

Even in a healthy person with a predisposition to diseases of the heart and blood vessels, using the definition of reactive protein, you can make a prediction of further development or lack thereof:

  • Low risk of development - indicators less than 1 mg / l.
  • Medium - concentration from 1 to 3 mg / l.
  • High - from 3 mg / l.

Already with a developed heart attack, by 18 to 20 days of the disease, the levels of C-reactive protein decrease. By 40 - 45 days in the absence of complications, the indicators return to normal. And in the case of a long and persistent increase, this phenomenon is considered extremely unfavorable.

For reference. The determination of CRP today is one of those methods of laboratory diagnostics, with which it is possible to evaluate the patient’s condition as quickly as possible, make a prognosis and determine the effectiveness of the treatment.

C-reactive protein increased, causes, treatment

  • Normally, the concentration of CRP in a healthy person varies between 0-5 mg / L.
Probability of developmentCRP, mg / l
Lowless than 1
Dangerous (requires re-examination for CRP and the appointment of additional diagnostic procedures)more than 10

Measure in mg per liter. In the absence of inflammation, reactive protein in the blood of adults is not detected or its level is less than 5 mg / liter. The norm for newborns is less than 1.6 mg / liter.

CRP - a non-specific marker of inflammation in the body

How to find the cause of protein increase

Only indicators of protein have no diagnostic value, because they reflect a general fact - protein metabolic disturbances, some kind of pathological process. In addition, changes may not be associated with the disease, but may be the result of impaired preparation for biochemical analysis. If you find "bad" indicators in the test protocol, it is better to consult a doctor.

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The specialist will evaluate the concentration of proteins along with other characteristics, interrogate the patient and examine. This will help narrow down the search for a provoking factor and find the optimal plan for an additional examination. You may need:

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  • general blood analysis,
  • urine and feces examination,
  • liver tests (AST, ALT),
  • detailed protein analysis,
  • allergy tests, tumor markers, PCR tests for infections and other specific tests,
  • CT, MRI, ultrasound of internal organs.

With increased protein and urea, kidney damage can be suspected. An increase in the concentration of proteins and cholesterol indicates atherosclerosis. If proteins, AST and ALT are greatly elevated, myocardial infarction is possible. By comparing various indicators, the doctor will be able to assess the severity of the situation, the need for urgent measures, the risk of irreversible consequences.

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Genetics and biochemistry

The CRP gene is located on the 1st chromosome at locus 1q21-q23. A protein molecule consists of 224 amino acid residues, has a molecular mass monomer of 25.106 kDa and is a five-membered ring disk in shape. Protein is a member of a small family of pentraxins (English pentraxin).

In the pentraxin family of proteins, CRP belongs to the class of pattern recognition receptors (PRRs).It was shown that all proteins of the pentraxin family are actively involved in acute immunological reactions, but CRP is one of the key components of humoral innate immunity, providing a link between the innate and adaptive immune systems.

CRP has long been recognized as a congenital opsonin, that is, a protein that can recognize microbes and facilitate their absorption by phagocytes. The prototype CRP ligand is phosphorylcholine, which binds to CRP in a calcium-dependent manner and is a component of most biological cell membranes, as well as many bacterial and fungal polysaccharides.

Do I need treatment

Hyperproteinemia cannot be treated. This is just a symptom that can be corrected by getting rid of a provoking factor. Therapy can be started only after a full examination and the establishment of the cause of the violations.

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If the deviations are caused by dehydration, the indicators will return to normal immediately after the restoration of the water-electrolyte balance in the body. Drugs can increase or decrease the protein level only if the failure is caused by disturbances in protein metabolism (in case of fermentopathies), without the help of a doctor. When hyperproteinemia is a consequence of the use of certain drugs, the doctor can replace them or completely cancel the treatment. It is impossible to independently decide on the termination of therapy.

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DRR functions

The synthesis of CRP occurs in response to inflammation in order to protect the body. Its production depends on the intensity of the pathological process, that is, the more pronounced the latter, the more reactive protein enters the blood. CRP activates the response of the immune system, affects all parts of the immune response. The functions of a reactive protein include the following:

  • increased leukocyte motility,
  • participation in the interaction of B- and T-lymphocytes,
  • complement system activation,
  • acceleration of phagocytosis, agglutination and precipitation reactions,
  • production of interleukins.

With successful treatment, the concentration of C-protein in plasma decreases after 6-10 days.

What analysis shows

With timely and effective treatment, a CRP blood test will show a decrease in protein concentration after a few days.

The indicator normalizes on the 7-14th day after the start of medication.

If the disease has passed from an acute stage to a chronic one, then the value of C-reactive protein in blood serum will gradually become equal to zero. But with an exacerbation of the disease, it will increase again.

A biochemical analysis of CRP blood makes it possible to distinguish between a viral infection and a bacterial infection. Since with the viral nature of the disease, the protein level does not increase much. But with a bacterial infection, even if it has just begun to develop, the concentration of C-reactive protein in the blood increases exponentially.

In a healthy person, CRP is normally negative.


Question: Are there special protein standards for pregnant women?

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Answer: During pregnancy, starting from the second trimester, the volume of circulating blood increases significantly. On this soil, its moderate "dilution" is possible - a decrease in the concentration of formed elements and other substances, including proteins. Usually, the changes do not go beyond the norm. If the indicator slightly "does not reach" the reference value, but there are no other disorders, and the expectant mother feels normal, hypoproteinemia is considered as a variant of the norm.

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Question: How dangerous is it for a pregnant woman and a fetus to increase protein indicators?

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Answer: Hyperproteinemia follows pathological changes in the body. Deviations can be the result of toxicosis in the early stages or a harbinger of gestosis in the later.The latter option is fraught with premature termination of pregnancy, because any deviations in the results of a biochemical test in a future mother require the attention of a doctor who observes a woman.

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Question: Can nutrition increase protein levels?

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Answer: This is really possible. All types of proteins are formed from amino acids that the body receives with food. If the diet of a person is dominated by meat, mushrooms, legumes, cottage cheese, eggs, milk, protein supplements in the form of sports nutrition, the deviations are quite real. Pathology and temporary impairment can be distinguished by C-reactive protein. If it is elevated, most likely the reason is not food.

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Question: How to eat with hyperproteinemia?

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Answer: It all depends on the reason. In most diseases, a healthy balanced diet with a normal content of proteins, fats and carbohydrates is indicated. An important aspect is the exclusion of all harmful products (sweets, sausages, smoked meats, alcohol, soda, muffin, fast food). Specific nutritional recommendations are completely dependent on the cause of the disorder. In case of kidney diseases, the amount of protein in the menu should be minimized, with intestinal damage there are no such restrictions, however, dishes should be consumed in a pureed form.

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Question: Can C-reactive protein increase with ARVI?

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Answer: It is, this substance will definitely respond to the virus invading the body. As a rule, changes in concentration are moderate. A significant increase is observed in severe infections, accompanied by inflammatory processes. For example, the additional growth of CRP indicates the attachment of bacteria to the virus, which indicates sinusitis, pneumonia, and other complications.

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When sent to a biochemical blood test for CRP

The doctor sends the patient a nbiochemical analysis of blood CRP in the following cases:

  1. Preventive examination of elderly patients.
  2. Determining the likelihood of cardiovascular complications in patients with diabetes, atherosclerosis, undergoing hemodialysis.
  3. Examination of patients with hypertension, coronary heart disease to prevent possible complications: sudden cardiac death, stroke, myocardial infarction.
  4. Identification of complications after coronary bypass surgery.
  5. Assessment of the risk of restenosis, recurrent myocardial infarction, death after angioplasty in patients with acute coronary syndrome or exertional angina.
  6. Monitoring the effectiveness of the prevention and treatment of cardiovascular complications using statins and acetylsalicylic acid (aspirin) in patients with cardiac problems.
  7. Collagenosis (to determine the effectiveness of therapy and the reactivity of the process).
  8. Monitoring the effectiveness of treating a bacterial infection (e.g., meningitis, neonatal sepsis) with antibacterial drugs.
  9. Monitoring the effectiveness of the treatment of chronic diseases (amyloidosis).
  10. Neoplasms.
  11. Acute infectious diseases.

Physiological role

CRP plays an important role in the removal of bioactive lysophospholipids and fatty acids from the body resulting from damage to their own cell membranes.

The fact is that in the absence of pathology, phosphatidylcholine, which is the main structural element of all cell membranes, is not found on the surface of cells, but when cells are damaged, phospholipids exchange between the outer and inner leaves of the membrane, resulting in enrichment of the outer sheet with phosphatidylserine and phosphatidylethanolamine, which usually found in the inner sheet.

This redistribution of phospholipids makes them more susceptible to hydrolysis of secretory phospholipase A2 and the subsequent generation of bioactive lysophospholipids (lysolecithin) and fatty acids, including arachidonic acid, which later turn into the strongest mediators of biochemical processes.

So, having high biological activity, lysophospholipids cause hemolysis (destruction) of red blood cells, have a lytic (destructive) effect on cell membranes, activate macrophages and enhance the formation of antibodies to soluble proteins and some other antigens.

In turn, the cleavage of phosphatidylcholine phospholipase A2 leads to the exposure of its head group on the cell membrane, which becomes the binding site of CRP to a damaged (or apoptotic) cell. The binding of CRP to damaged cells leads to the further removal of their residues.

According to the most common concept, this process is carried out due to the ability of CRP to strengthen the classical complement activation pathway on the surface of apoptotic cells, which facilitates the absorption of these cells by macrophages that have complement receptors CR3 and CR4.

However, in accordance with the results of experimental studies of S.P. Hart (Hart S.P., 2005), CRP is not involved in opsonization in the early stages of apoptosis of human neutrophils, since it can only bind to the structures of the inner leaf of the cell membrane, which appear on the cell surface only in the late stages of apoptosis.

Moreover, there was no evidence that CRP, by binding to FcγRIIA, is able to influence macrophage on the phagocytosis of apoptotic cells.
It was shown that in addition to binding to phosphatidylcholine, CRP can also bind to a nuclear antigen, which is an autoantigen,

however, it binds not to native DNA (naked DNA), but to small nuclear ribonucleoprotein particles (snRNP). By binding to nuclear structures, CRP also activates complement, which leads to improved opsonization of potential autoantigens.

  • The data obtained by researchers on the ability of CRP to facilitate the clearance of cell apoptosis products by binding to nuclear antigens led to the theory of “waste elimination”, which, by masking autoantigens from the immune system, or by increasing their excretion, CRP prevents the development or reduces autoimmune diseases .
  • There is evidence that, in addition to complement activation along the classical pathway, CRP, due to the formation of a bond with factor H, which is a soluble glycoprotein circulating in human plasma, is able to regulate complement activation along an alternative pathway.
  • It is important to note that factor H binds to glycosaminoglycans, which are usually present on the host cells but not on the surface of the pathogen; therefore, the interaction of CRP with factor H occurs only locally at the sites of damage, thereby limiting the excessive complement activity in tissues.

Another protein that CRP interacts with is M-ficolin, which can recognize pathogens and participate in complement activation.

M-ficolin is expressed by myeloid cells and type II alveolar epithelial cells, and in addition, recent studies have shown that it is secreted into the extracellular medium (blood plasma) by monocytes and macrophages.

It has now been shown that soluble lectins (including M-ficolin) of monocytic origin are able to overcome the absence of their own membrane anchor by docking with transmembrane receptor-43 monocytes associated with G-proteins (GPCR43).

Moreover, the induction of conformational changes in the M-ficolin molecule, which provides the interaction between the C-reactive protein and the M-ficolin / GPCR43 complex, is stimulated even by mild acidosis at the site of injury. As a result of this interaction, the production of IL-8 is limited, and thus excessive immune activation is prevented.

It should be noted that in humans, the ability of CRPs to bind Fc receptors (CD64) to monomeric IgG isomeric immunoglobulins with high affinity plays a significant role in anti-inflammatory processes, since only humans have the FcγRI receptor, which has a high affinity for IgG.

Diagnostic value

C-reactive protein is a non-specific indicator of inflammation with a very high sensitivity to any tissue damage. A sharp increase in its concentration in the blood occurs during the first four hours of the disease.Thus, C-reactive protein in the blood is the very first sign of an infectious disease, reflecting the intensity of the process.

How to prepare for analysis

Venous blood is donated to a biochemical blood test for CRP. On the eve of blood sampling, you must follow simple rules:

  • Do not drink alcohol, fatty and fried foods.
  • Try to avoid physical and emotional stress.
  • Last meal 12 hours before analysis.
  • You can not drink juice, tea and coffee before the study. You can quench your thirst only with non-carbonated water.
  • Do not smoke 30 minutes before blood donation.

Decryption of analysis

The doctor should decrypt the blood test for CRP. Only a specialist can correctly assess how much the level of C-reactive protein has increased, compare this with the symptoms and prescribe the appropriate treatment.

Although normal biochemical analysis of CRP blood is negative, reference positive values ​​from 0 to 5 mg / L are accepted. Consider the indicators of CRP and condition, they are shown in the table.

CRP indicatorDecryption
3 mg / la high probability of cardiovascular disease in almost healthy people, as well as a high probability of complications in patients
CRP> 10 mg / Lcarry out a repeated blood test an additional diagnostic examination to identify the cause of the disease

What is it prescribed for?

A blood test for CRP is required in the following cases:

  • diagnosis of acute infections,
  • determining the likelihood of developing cardiovascular complications in diabetes, atherosclerosis and in patients on hemodialysis,
  • tumor diagnosis
  • evaluation of the effectiveness of the treatment of chronic diseases,
  • determination of the development of organ rejection after transplantation,
  • evaluation of the effectiveness of antibiotic therapy,
  • determination of the extent of necrosis after myocardial infarction,
  • identification of complications in the period after surgery,
  • determination of the reactivity of the process in diffuse diseases of the connective tissue and evaluation of the effectiveness of the treatment.

The study is prescribed in the following cases:

  • examination of healthy older people,
  • examination of patients with coronary heart disease and hypertension in order to prevent death from stroke or heart attack,
  • after undergoing a course of treatment of cardiovascular diseases in order to assess its effectiveness,
  • after coronary bypass surgery,
  • after angioplasty in patients with angina pectoris and acute coronary syndrome in order to determine the likelihood of death.

C-reactive protein during pregnancy

Increased CRP is not dangerous for a pregnant woman, if other tests are normal. Otherwise, it is necessary to look for the cause of the inflammatory process. With toxicosis, indications can increase to 115 mg / l.

If increased to 8 mg / l from 5 to 19 weeks, a risk of miscarriage is created. The cause of an increase in CRP can be viral infections (if the indicator is up to 19 mg / l), bacterial infections (if the indicator is above 180 mg / l).

CRP and cardiovascular disease

The relationship between CRP and cardiovascular disease has been studied for many years, the results are described in a number of original and review studies.

Most often, the conclusions about the possibility of CRP participation in the pathogenesis of atherosclerosis and acute myocardial infarction are based on its ability to activate complement and the facts of CRP detection on low density lipoproteins, on damaged and dead cells.

So, back in 1978, I. Kushner (Kushner I and all., 1978) reported on the association of the rapid synthesis of CRP with acute myocardial infarction in humans, and in the works of De Beer and colleagues (de Beer and all., 1982) it was noted that a stably elevated concentration of circulating CRP after a heart attack significantly correlated with a poor prognosis of the disease.

The data obtained were confirmed in large randomized trials.
It is believed that determination of plasma CRP concentration allows predicting not only the development of arterial thrombosis, but also a post-infarction prognosis, while an increase in CRP level is a risk factor for both non-fatal and fatal MI.

Moreover, there is evidence that CRP may be a reliable marker of the risk of restenosis after percutaneous coronary interventions. According to published data, a comparison of CRP levels in patients with unstable angina, acute myocardial infarction with ST segment elevation (STEMI), and acute myocardial infarction without ST segment elevation (Non-STEMI) showed that CRP was increased (gt

3 mg / l) in 27.6% of patients with unstable angina, in 70.9% in the STEMI group and in 77.9% in the Non-STEMI group. At the same time, in patients with elevated levels of CRP, acute heart attacks occurred 3 times more often than in patients with CRP lt, 3 mg l.

A comparison of the role of CRP in the development of IHD in men with the role of other basic participants in the acute phase of inflammation showed that men with high CRP levels had significantly more chances for the development of IHD.

It is important that an increased plasma CRP level allows predicting the risk of myocardial infarction and thromboembolic stroke even in practically healthy men, which to some extent supports the hypothesis about the important role of chronic inflammation in the pathogenesis of atherothrombosis.

Similar data were obtained in women.

The special role of inflammation and CRP in the onset of MI is supported by data from an analysis of 8.5-year follow-up of patients with elevated CRP during a Helsinki study (Helsinki Heart Study, 1987), according to which, in patients with high levels of antibodies and a high level of CRP, the risk of developing myocardial infarction or coronary death significantly and significantly increased.

Also, certain evidence that not the degree of atherosclerotic lesion of the coronary vessels, but rather the high level of CRP plays a major role in predicting the occurrence and possibly the formation of MI, is indicated by the fact that highly sensitive methods for determining CRP can detect the risk of MI even in people with low and moderate lipid levels.

Reasons for deviations

  • Acute bacterial (neonatal sepsis) and viral (tuberculosis) infections.
  • Meningitis.
  • Postoperative complications.
  • Neutropenia
  • Diseases of the gastrointestinal tract.
  • Tissue damage (trauma, burn, surgery, acute myocardial infarction).
  • Malignant neoplasms and metastases. (an increase in CRP is observed in cancer of the lungs, prostate gland, stomach, ovaries and other localizations of tumors)
  • Arterial hypertension.
  • Diabetes.
  • Overweight.
  • Disruption of the hormonal background (high levels of progesterone or estrogen).
  • Systemic rheumatic diseases.
  • Atherogenic dyslipidemia (lowering cholesterol, increasing the concentration of triglycerides).
  • Chronic inflammatory process associated with an increased likelihood of cardiovascular disease and the occurrence of their complications.
  • Exacerbation of chronic inflammatory (immunopathological and infectious) diseases.
  • Graft rejection reaction.
  • Myocardial infarction (elevated CRP is determined on the 2nd day of the disease, by the beginning of the 3rd week the value of C-reactive protein returns to normal).
  • Secondary amyloidosis.

What can affect the result of the analysis

  • Pregnancy, taking oral contraceptives, intense physical activity, hormone replacement therapy, smoking can be the reason for the increased value of the blood CRP test.
  • Taking beta-blockers, statin drugs, corticosteroids, non-steroidal anti-inflammatory drugs (ibuprofen, aspirin) can reduce the concentration of CRP in blood serum.
  • If it is necessary to establish the baseline value of C-reactive protein, then CRP blood test should be taken 2 weeks after the disappearance of symptoms of any acute or exacerbation of a chronic disease.

General information

CRP is produced in the liver cells (hepatocytes) immediately after the damage, which can be caused by bacteria, fungi, antigens, various immune complexes, etc.

The level of C-reactive protein directly depends on the type, form (acute, chronic), stage and activity of the disease. In the first 4-6 hours after cell damage, the active synthesis of CRP begins, and after a day its density increases exponentially.

With early diagnosis of the disease and timely treatment, after a few days the analysis will show a decrease in the concentration of CRP. The full indicator will be reset only after 1-2 weeks after the start of conservative therapy.

Chronic pathologies are characterized by a wave-like course, respectively, and CRP will increase during the period of exacerbation and independently decrease during remission (subsiding of clinical symptoms).

A biochemical blood test with the determination of CRP values ​​allows you to distinguish a bacterial disease from a viral, fungal or parasitic one.

It is known that with viral pathology, CRP does not increase much, but in the case of a bacterial infection it can increase several times.

Also, a high concentration of C-reactive protein may indicate malignant neoplasm, trauma or necrosis (death) of tissues.

An important role in the analysis of CRP is in the diagnosis of atherosclerosis. If the plasma protein level rises, then we can talk about the pathology of the vascular walls and the beginning of the inflammatory process. Additional diagnostics will reveal which disease is developing: stroke or heart attack, coronary artery disease, hypertension, atherosclerosis, etc.

In newborns, liver function is insufficient, therefore, the level of C-reactive protein may not increase even in acute inflammatory processes and sepsis (blood infection). Antibacterial treatment of infants should begin when the concentration of CRP is exceeded by more than 12 mg / L.

Why rises?

Also read:Biochemical blood test

  1. Acute infections: bacterial, fungal, viral. In some bacterial diseases, such as meningitis, tuberculosis, neonatal sepsis, the level can be increased to 100 mg per liter and higher. With viral lesions, this indicator does not increase much.
  2. Autoimmune processes: rheumatoid arthritis, systemic vasculitis, Crohn's disease. Moreover, the higher the protein concentration, the harder the pathology.
  3. Myocardial infarction. As a rule, the level of CRP increases after 18-32 hours after the onset of the disease, decreases by the twentieth day and normalizes to the fortieth. An adverse sign in this case is a significant increase in the level of CRP.
  4. Acute complicated pancreatitis, pancreatic necrosis.
  5. Damage to tissues with injuries, burns.
  6. CRP is elevated after surgery. The concentration is especially high immediately after surgery, then there is a rapid decline. A high level of reactive protein may indicate inflammation that began after surgical manipulations and the rejection of transplanted tissues.
  7. Malignant tumors of any localization: cancer of the lung, stomach, prostate, ovaries, etc.
  8. Diseases of the digestive system.
  9. Diabetes.
  10. Overweight.
  11. Arterial hypertension.

In addition, an increase in reactive protein is possible:

  • with severe physical exertion,
  • during pregnancy
  • as a result of taking oral contraceptives,
  • with hormone replacement therapy,
  • people with bad habits, in particular smokers.

Norm for C-reactive protein

  • Normally, the concentration of CRP in a healthy person varies between 0-5 mg / L.

To assess the risk of developing cardiovascular pathologies, the following values ​​can be used:

Probability of developmentCRP, mg / l
Lowless than 1
Dangerous (requires re-examination for CRP and the appointment of additional diagnostic procedures)more than 10

Interpretation of Results

Normally, in the blood of a healthy person, C-reactive protein is absent altogether or is in a negligible concentration.

Exceeding the norm of CRP can indicate the following pathologies:

  • acute bacterial diseases (sepsis in newborns, tuberculosis),
  • meningitis (inflammation of the soft tissues around the brain),
  • postoperative complications (wound infection, sepsis),
  • neutropenia (decrease in blood neutrophil concentration),
  • tissue damage due to trauma, surgery, burns,
  • acute myocardial infarction,
  • malignant processes in the body with metastasis,
  • hypertensive crisis (a sharp increase in pressure to individually high numbers),
  • diabetes mellitus (increased blood glucose),
  • hormonal disruptions (increased hormones of estrogen or progesterone),
  • systemic rheumatic pathologies,
  • atherogenic dyslipidemia (reduced concentration of "normal" cholesterol with an increase in triglycerides),
  • chronic cardiovascular pathologies (coronary heart disease, angina pectoris),
  • relapse of infectious and inflammatory processes,
  • transplant rejection rejection reaction,
  • secondary amyloidosis (impaired protein metabolism).

It should be borne in mind that the concentration of C-reactive protein for various diseases is significantly different.

  • With viral pathologies, metastatic cancer (stage 4), as well as sluggish rheumatic diseases, the protein level can be increased moderately - up to 30 mg / l,
  • In recurrent chronic inflammatory diseases, bacterial infections, acute myocardial infarction, the concentration of C-reactive protein may be in the range of 40-100 mg / L. The same values ​​are observed in patients in the postoperative period,
  • Generalized infections, extensive burns, sepsis and other conditions that threaten human life and health can give ultra-high values ​​- more than 300 mg / l,

An increased concentration of CRP in healthy people in the absence of complaints and clinical symptoms may indicate the development of oncology.

C-reactive protein is elevated: what does it mean, the norm in men, women and children

One of the important indicators of a biochemical blood test is C-reactive protein. Its value helps determine the state of human health.

The patient is often asked: if C-reactive protein is elevated, what does this mean in an adult? An increase in CRP is observed in people of different ages. This is the reactive protein that our liver produces.

A high level of CRP means that an acute or chronic disease develops in the body.

The role of CRP in the human body

The highly sensitive C-reactive protein activates the complementary system and is responsible for enhancing immunity. In the acute phase of the disease, 30 proteins protect our body. These include CRP. Its level in the biochemical analysis of blood rises 5-6 hours after the onset of the disease. After 2-3 days, the maximum value of the indicator is observed. The forces that protect our body enter the fight against the disease.

If the C-reactive protein in the blood is increased, this means:

  • stimulation of the work of other protective cells,
  • activation of substances that kill viruses and germs.

Elevated CRP can harm a person, adversely affecting the processes of fat metabolism. Cholesterol occurs on the walls of blood vessels. High cholesterol provokes the appearance of “atherosclerotic plaques“. They are deposited on the walls of arteries. Vascular atherosclerosis is the cause of hypertension and coronary heart disease.

During the recovery period, the liver gradually stops producing C-reactive protein. In a blood test, a clear decrease in its performance is observed. Every 19-20 hours, the figure becomes half as much. After the patient recovers, CRP finally returns to normal.

Why CRP Rises

  • all types of inflammation,
  • malignant neoplasms,
  • atherosclerosis of the central arteries.

Each item can be expanded with a long list of diseases. They need to be diagnosed and treated, focusing on such indicators:

  • more than 100 mg / l - bacterial pneumonia, shigellosis and salmonellosis, kidney disease,
  • from 20 to 50 mg / l - viral pathologies: (herpes, infectious mononucleosis, company - and adenoviruses),
  • 19 mg / l or less - the indicator is exceeded slightly.

On a note!

The latest laboratory diagnostic methods allow you to determine CRP in 30 minutes.

In addition, injuries, severe burns, organ rejection after transplantation, and helminthic invasions contribute to an increase in the level of C-reactive protein. Some reasons are reflected in the table:

CauseType of pathological processThe increase in C-reactive protein (in mg / l)
Acute infectionsBacterial damage to the body (especially after surgery)80 - 1000 (high numbers)
Other acute infectionsViral damage to the body10-30 (average figures)
Inflammatory processesAny acute or chronic disease (rheumatism, Crohn’s disease)40-200 and more (high numbers)
Sluggish inflammatory processesA wide range of diseases (including autoimmune nature)10-30
Noncommunicable Diseases and ConditionsTraumatic injuries of organs and tissues, complex surgery, organ rejection after transplantation, all types of burns, heart attacks, any stage of obesity, diabetes mellitus, strokes300 and more

Normal performance in children

C - reactive protein in children is first determined in a maternity hospital. CRP in a small child can be increased to 1.6 mg. In general, the standards for children are the same as for adults.

Some children after birth suffer from a form of benign agranulocytosis. He disappears by the third year of the baby's life, so treatment is not necessary.

If the level of CRP in the blood is elevated, childhood infections may be the cause.

How is C-reactive protein determined?

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

Recommended by:

  • It is necessary to take biochemistry in the morning on an empty stomach.
  • Do not eat before the test for 12 hours, and only normal water is allowed to drink.
  • Before the procedure and the day before it, it is necessary to avoid stressful situations and heavy physical exertion.
  • Do not smoke before donating blood.

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 results within a few hours after blood sampling.

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

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

A similar study is carried out with:

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

What to do when increasing with reactive protein in the blood

It all depends on what the analysis shows. If CRP is high, you need to find out why this happens, diagnose a possible disease and prescribe the right treatment. For an accurate diagnosis, the doctor prescribes a number of additional examinations.

The norm of CRP can fluctuate due to stress and an improper lifestyle.Bad habits also contribute to the development of dangerous diseases. It is important to observe the measure in everything, and then the risk of diseases will be minimized.

C-reactive protein, quantitatively (highly sensitive method)

06-050 C-reactive protein, quantitatively (highly sensitive method)

400 rub

  • An acute phase protein, the long-term elevated content of basic concentrations of which in the blood indicates an inflammatory process in the vessel wall, the development of atherosclerosis and is associated with a risk of developing cardiovascular diseases and their complications.
  • Synonyms Russian
  • CRP.
  • Synonyms English
  • High-sensitivity C-reactive protein (hs-CRP), quantitative, Cardio CRP, High-sensitivity CRP, Ultra-sensitive CRP.
  • Research method
  • Immunoturbidimetry.
  • Units
  • Mg / L (milligrams per liter).
  • What biomaterial can be used for research?
  • Venous blood.
  • How to prepare for the study?
  • Do not eat for 12 hours before testing.
  • Eliminate physical and emotional stress 30 minutes before the study.
  • Do not smoke for 30 minutes before the study.

Study Overview

C-reactive protein is a glycoprotein produced by the liver and belongs to the proteins of the acute phase of inflammation.

Under the influence of anti-inflammatory cytokines (interleukin-1, tumor necrosis factor-alpha, and especially interleukin-6), its synthesis increases after 6 hours, and the concentration in the blood increases 10-100 times within 24-48 hours after the onset of inflammation.

The highest levels of CRP (more than 100 mg / l) are observed with bacterial infection. With a viral infection, the level of CRP, as a rule, does not exceed 20 mg / l. The concentration of CRP also increases with tissue necrosis (including myocardial infarction, tumor necrosis).

CRP is involved in the activation of complement (a group of proteins that are part of the immune system), monocytes, stimulation of the expression of ICAM-1, VCAM-1, E-selectin adhesion molecules on the endothelium surface (they provide cell interaction), binding and modification of low density lipids (LDL) , that is, contributes to the development of atherosclerosis.

According to recent studies, sluggish inflammation in the vessel wall plays a major role in the development of atherosclerosis, which, in turn, is associated with the occurrence of cardiovascular diseases.

“Classical” risk factors for cardiovascular diseases contribute to damage to the vascular wall, inflammation, and an increase in CRP: smoking, obesity, and a decrease in the sensitivity of tissues to insulin.

A slightly increased basic level of CRP, which can only be determined thanks to highly sensitive analytical methods, reflects the activity of inflammation in the inner lining of the vessels and is a reliable sign of atherosclerosis.

Some studies indicate that patients with elevated CRP and normal LDL have a greater risk of developing cardiovascular disease than patients with normal CRP and high LDL.

A relatively elevated CRP level, even with normal cholesterol in healthy individuals, allows us to predict the risk of hypertension, myocardial infarction, stroke, sudden cardiac death, type 2 diabetes mellitus and peripheral vascular atherosclerosis.

In patients with coronary heart disease, excessive CRP is a bad sign and indicates a high risk of repeated heart attack, stroke, restenosis with angioplasty and complications after coronary artery bypass grafting.

Acetylsalicylic acid and statins reduce the level of CRP in the blood, which reduce the activity of inflammation in the vessel wall and the course of atherosclerosis. Regular physical activity, moderation in alcohol consumption, as well as normalization of body weight lead to a decrease in CRP and, consequently, the risk of vascular complications.

As you know, among the causes of mortality in the adult population of developed countries, cardiovascular diseases and their complications take first place.

Studies of CRP level in combination with other indicators help to assess the likely risk of developing cardiovascular diseases in relatively healthy people, as well as to predict the course of the disease in cardiac patients, which can be used for preventive purposes and when planning treatment tactics.

What is the study used for?

  • To assess the risk of developing cardiovascular disease in healthy individuals (along with other markers).
  • To predict complications (myocardial infarction, stroke, sudden cardiac death) in individuals with coronary heart disease and hypertension.
  • To assess the effectiveness of the prevention of cardiovascular diseases and their complications.

When is the study scheduled?

  • With a comprehensive examination of healthy individuals of older age groups.
  • When examining patients with coronary heart disease, hypertension.
  • During treatment and prevention of cardiovascular complications, while taking aspirin (acetylsalicylic acid) and statins in patients with a cardiological profile.
  • After angioplasty in patients with exertional angina or acute coronary syndrome (to assess the risk of death, recurrent myocardial infarction, restenosis).
  • After coronary bypass surgery (to identify early postoperative complications).
  1. What do the results mean?
  2. Reference values: 0 - 1 mg / l.
  3. A CRP concentration of less than 1 mg / L indicates a low risk of developing cardiovascular diseases and their complications, 1-3 mg / L - an average risk, more than 3 mg / L - a high risk of vascular complications in healthy individuals and in patients with cardio vascular diseases.
  4. If the level of CRP exceeds 10 mg / l, a second test and an additional examination are performed to identify infectious and inflammatory diseases.

CRP greater than 10 mg / l indicates acute inflammation, chronic disease, trauma, etc.

Reasons for increasing C-reactive protein:

  • acute viral and bacterial infections,
  • exacerbation of chronic inflammatory (infectious and immunopathological) diseases,
  • tissue damage (trauma, surgery, acute myocardial infarction),
  • malignant neoplasms and metastases,
  • burns
  • sepsis,
  • chronic sluggish inflammatory process associated with an increased risk of cardiovascular diseases and their complications,
  • smoking,
  • arterial hypertension,
  • overweight
  • diabetes,
  • atherogenic dyslipidemia (a decrease in the concentration of HDL cholesterol, an increase in the concentration of triglycerides, LDL cholesterol),
  • hormonal imbalance (increased levels of estrogen and progesterone).

What can influence the result?

Factors that increase the level of CRP:

  • pregnancy, intense physical activity,
  • taking oral contraceptives, hormone replacement therapy.

Factors that reduce the level of CRP:

  • taking non-steroidal anti-inflammatory drugs (aspirin, ibuprofen), corticosteroids, statins, beta-blockers.

Important notes

It is advisable to evaluate the basic level of CRP not earlier than 2 weeks after the disappearance of the symptoms of any acute disease (or exacerbation of a chronic disease). With a significant increase in CRP more than 10 mg / l, an additional examination is necessary to clarify the causes of the inflammatory process.

Highly sensitive hs-CRP test

To identify pathologies of the cardiovascular system, a special highly sensitive hs-CRP test is performed.. It allows even a slight increase in protein to be detected, which is of great help in calculating the risks of heart and vascular diseases.

In women and men, the determination of the risk of cardiovascular pathologies is most often carried out with the help of cholesterol analysis. The 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.

An analysis of 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. In contrast to ESR, CRP analysis gives a more accurate result and tracks the slightest changes in the body.

Watch the video: C-Reactive Protein CRP. Inflammation. Acute phase reactant (February 2020).