原文地址

https://todaysveterinarypractice.com/diagnostics/c-reactive-protein-in-dogs/

C-Reactive Protein in Dogs: A Review for the General Practitioner

犬C反應蛋白（C-Reactive Protein）：臨床回顧

CRP concentration levels are emerging as a promising prognostic indicator and noninvasive tool for the management of dogs with a range of inflammatory diseases

CRP濃度水平正在成為一種有潛力的預后指標和非侵入性指標，
用于管理一系列犬的炎癥性疾病。

June 16, 2023?| Issue:?July/August 2023

Sydney Oberholtzer?DVM?

Audrey Cook?BVM&S, MSc VetEd, MRCVS, DACVIM (SAIM), DECVIM-CA, DABVP (Feline)

Abstract 摘要

C-reactive protein (CRP) is produced by the liver in response to inflammation and can be reliably measured in canine serum. Circulating concentrations of CRP increase within 24 hours of tissue injury in dogs and may be used as both a prognostic indicator (e.g., acute pancreatitis) and a management tool (e.g., immune-mediated polyarthritis, pneumonia) in routine companion animal practice.

C反應蛋白(CRP)是由肝臟對炎癥反應產(chǎn)生的，可以在犬血清中可靠地測量。

在犬的組織損傷后24小時內(nèi)，CRP血液循環(huán)濃度升高，
可作為預后指標(如急性胰腺炎)
和常規(guī)伴侶動物臨床實踐中的管理工具(如免疫介導的多發(fā)性關節(jié)炎、肺炎)。

This article summarizes the current understanding of CRP in canine patients and outlines specific conditions in which this novel biomarker may be diagnostically or therapeutically useful.

本文總結了目前對犬病患CRP的認識，
并概述了這種新型生物標志物可能在診斷或治療方面有用的具體情況。

Take-Home Points

要點

• Serum concentrations of C-reactive protein (CRP) increase within 4 to 24 hours of the onset of inflammation in dogs.

• CRP measurements can be used during initial patient assessment or to determine the response to therapy.

• Specific conditions in which CRP has been investigated in dogs include immune-mediated diseases, neoplasia, pneumonia, discospondylitis, and pancreatitis.

• CRP assays are offered by veterinary reference laboratories and can be performed on in-house analyzers.

• 本文總結了目前對犬病患CRP的認識，并概述了這種新型生物標志物可能在診斷或治療方面有用的具體情況。犬的血清C反應蛋白(CRP)濃度在炎癥起始后4至24小時內(nèi)升高。

• CRP測量可用于初始病患評估或確定對治療的反應。

• 研究CRP在犬類中的具體情況包括免疫介導的疾病、腫瘤、肺炎、脊柱炎和胰腺炎。

• CRP檢測由獸醫(yī)參考實驗室提供，并可在院內(nèi)分析儀上進行。

Positive acute-phase proteins are produced by the liver in response to tissue damage and play a key role in innate responses to injury and infection. Members of this group include C-reactive protein (CRP), haptoglobin, and serum amyloid A. Of these, CRP is the most well-established. It was first identified in the 1930s in humans with pneumococcal pneumonia and is now widely?regarded as a sensitive biomarker of inflammation?in human patients with a range of disorders. Despite this long-standing history in human medicine, measurement of CRP has only?recently gained traction in the veterinary community.

陽性急性期蛋白是由肝臟對組織損傷的反應產(chǎn)生的，
在對損傷和感染的先天反應中起關鍵作用。

這一組的成員包括
? ? C反應蛋白(C-reactive protein?CRP)，
? ? 觸珠蛋白/結合珠蛋白（haptoglobin）
? ? 和血清淀粉樣蛋白A（serum amyloid A）。

其中，CRP是最確實已久的。

它最初于20世紀30年代在肺炎球菌肺炎病患中被發(fā)現(xiàn)，
現(xiàn)在被廣泛認為是一系列疾病病患炎癥的敏感生物標志物。

盡管人類醫(yī)學有著悠久的歷史，
但CRP的測量直到最近才在獸醫(yī)界得到關注。

In healthy dogs, CRP concentrations are generally less than 20 mg/L (i.e., 20 μg/mL). However, hepatic synthesis of CRP is rapidly stimulated by interleukins 1 and 6, resulting in increased serum levels within 4 to 24 hours of infection or the onset of inflammation. Depending on the nature of the insult or injury, concentrations may increase by 10- to 1000-fold, with a peak response between 24 and 48 hours. CRP levels typically begin to decline 18 to 24?hours after the initiation of appropriate treatment or mitigation of the inciting cause.1

在健康犬中，
CRP濃度通常小于20 mg/L(即，20μg/mL)。

然而，
白細胞介素1和6可迅速刺激肝臟合成CRP，
導致感染或炎癥發(fā)生后4至24小時內(nèi)血清CRP水平升高。

根據(jù)病變或損傷的性質(zhì)，
濃度可升高10至1000倍，
在24至48小時之間達到峰值。

C反應蛋白水平通常在開始適當治療或緩解誘因后18至24小時開始下降。

In dogs, increases in CRP have been reported in patients with a range of conditions, including numerous infections (e.g., parvoviral enteritis, pyometra), sterile inflammatory conditions (e.g., pancreatitis), and cancers (e.g., lymphoma).2?As serum concentrations are not influenced by age, sex, or breed, this biomarker offers significant promise as an aid to the diagnosis of a wide range of diseases.

在犬，
有報道稱在多種情況下，
包括
? ? 各類感染(如細小病毒性腸炎、子宮蓄膿)、
? ? 無菌性炎癥(如胰腺炎)
? ? 和癌癥(如淋巴瘤)病患中，
CRP升高。2

由于血清濃度不受年齡、性別或品種的影響，
這種生物標志物為廣泛疾病的診斷提供了重要的幫助。

When Is it Helpful to Measure CRP?

什么時候測量CRP有幫助?

In patients presenting with signs of inflammation such as pyrexia, depression, or dehydration, practitioners have traditionally relied on hematologic findings, along with serum globulin concentrations, to assess disease severity. Decreases in negative acute-phase proteins such as albumin may also be informative. However, CRP appears to be a more sensitive laboratory marker for identification and monitoring of inflammation in dogs.3?White blood cell counts, for example, may remain elevated for several days despite resolution of the underlying inflammatory condition. In addition, treatment protocols that rely on glucocorticoids may induce a persistent leukocytosis, despite effective management of the underlying disease.

在出現(xiàn)發(fā)熱、沉郁或脫水等炎癥癥狀的病患中，
醫(yī)生傳統(tǒng)上依靠血液學結果以及血清球蛋白濃度來評估疾病的嚴重程度。

陰性急性期蛋白如白蛋白的減少也可能提供信息。

然而，
CRP似乎是一種更敏感的實驗室標志物，
用于識別和監(jiān)測犬的炎癥
例如，
盡管潛在的炎癥狀況得到緩解，
白細胞計數(shù)仍可能持續(xù)升高數(shù)天。

此外，
依賴糖皮質(zhì)激素的治療方案可能誘發(fā)持續(xù)的白細胞增多，
即使對潛在疾病進行了有效的管理。

Because CRP increases between 4 and 24 hours after the initiation of systemic inflammation, elevated concentrations are expected when the patient is first presented. Subsequent measurements should be performed within 18 to 24 hours of the initiation of treatment to assess response. Follow-up CRP concentrations can be measured as necessary to monitor the ongoing response to therapy.

由于CRP在全身性炎癥發(fā)生后4 - 24小時內(nèi)升高，
因此病患首次就診時，
CRP濃度預計會升高。

后續(xù)測量應在治療開始后18至24小時內(nèi)進行，
以評估反應。

隨訪時可以測量CRP濃度，
以監(jiān)測對治療的持續(xù)反應。

What Do We Know About CRP in Dogs?

我們對犬的CRP了解多少?

CRP concentrations have been used to identify inflammation in numerous conditions, many of which are listed in?BOX 1.4-17?More data are available on the usefulness of CRP in dogs with specific conditions; this information is summarized below.

C反應蛋白濃度已被用于識別多種情況下的炎癥，
其中許多疾病列在方框1中。4-17

有更多關于C反應蛋白對犬特定情況下的有用性的數(shù)據(jù);
這些信息總結如下。

BOX 1 Diseases Associated With Increased CRP Concentrations in Dogs?a

方框1? ?與犬CRP濃度升高相關的疾病 a

• Bacterial pneumonia?4,5 細菌性肺炎

• Immune-mediated polyarthritis 6 免疫介導性多發(fā)性關節(jié)炎

• Immune-mediated hemolytic anemia 7 免疫介導性溶血性貧血

• Neoplasia?8,9 腫瘤

• Chronic enteropathy 10 慢性腸病

• Acute pancreatitis 11 急性胰腺炎

• Postsurgical trauma/infection?12,13 術后創(chuàng)傷/感染

• Endocarditis?14 心內(nèi)膜炎

• Leptospirosis?15 鉤端螺旋體病

• Congestive heart failure 14? 充血性心力衰竭

• Discospondylitis 16 椎間盤脊柱炎

• Tick-borne diseases?(e.g, ehrlichiosis, babesiosis, hepatozoonosis)?17 蜱媒介疾?。ㄈ?，埃利希體病，巴貝斯蟲病，肝簇蟲?。?/p>

• Escherichia coli?endotoxemia?2 大腸桿菌性內(nèi)毒素血癥

• Viral disease (e.g.,?parvovirus)?2 病毒性疾?。ㄈ?，細小病毒）

CRP = C-reactive protein C-反應蛋白

a?This is not an exhaustive list; other systemic inflammatory conditions also cause elevations in CRP.

a 這不是一份詳盡的清單;
? ?還有其他全身性炎癥也會導致CRP升高。

Pneumonia 肺炎

Coughing and tachypnea are common presenting complaints for canine patients in both general and emergency practices. Although radiographic findings may narrow down the list of possible causes, it can be difficult to establish a definitive diagnosis and determine the need for antibiotic therapy without invasive testing (see?Case Example sidebar).

咳嗽和呼吸急促是一般臨床和急診的常見的犬病患表現(xiàn)主訴。

雖然X線檢查結果可以縮小可能原因的范圍，
但在沒有侵入性檢查的情況下，
很難確定明確的診斷并確定是否需要抗生素治療(見Case Example sidebar)。

Case Example: C-Reactive Protein (CRP) Concentrations in a Dog With Pneumonia

病例: C反應蛋白(CRP)濃度的與一例犬肺炎

A 6-year-old male castrated miniature dachshund presented with acute-onset cough and lethargy. The dog had a long-standing history of aspiration pneumonia secondary to idiopathic megaesophagus. Thoracic radiographs?(FIGURE 1)?were consistent with aspiration pneumonia. The patient’s CRP level was greater than 60 mg/L (reference range, <10 mg/L) and he was started on oral amoxicillin/clavulanate.

一例6歲雄性已絕育的迷你臘腸犬表現(xiàn)為急性咳嗽和嗜睡。

該犬有長期的吸入性肺炎，繼發(fā)于特發(fā)性巨食道。

胸片(圖1)符合吸入性肺炎。

病患的CRP水平大于60mg/L(參考范圍，10mg/L)，
開始口服阿莫西林/克拉維酸。

圖1A。
就診時的胸左側位X線片。(A和B)
右前肺葉和右中肺葉(圈內(nèi))可見明顯的肺泡型。
(A)可見充滿空氣的食道(箭頭)。
由德州農(nóng)工大學診斷影像服務提供

圖1B。

就診時胸腹背位X線片。(A和B)
右前肺葉葉和右中肺葉(圈內(nèi))可見明顯的肺泡型。
由德州農(nóng)工大學診斷影像服務提供

Follow-up radiographs taken 3 weeks later?(FIGURE 2)?showed substantial improvement; the patient was reported to be active and eating well. However, there was a persistent unstructured interstitial pulmonary pattern in the right cranial lung lobe. This was likely fibrosis secondary to prior pneumonia, but ongoing active disease could not be excluded based on radiographic findings alone. CRP was 10 mg/L at this time; antibiotics were therefore discontinued.

3周后的隨訪X線片(圖2)顯示有明顯改善;
據(jù)報道，該病患活躍，飲食健康。

然而，在右前肺葉有一個持續(xù)的非結構化的間質(zhì)肺型。

這可能是繼發(fā)于既往肺炎的纖維化，
但僅根據(jù)影像學表現(xiàn)不能排除持續(xù)的活躍性疾病。

此時CRP為10 mg/L;
抗生素因此停止使用。

圖2A。

抗生素治療3周后拍攝的胸左側位X線片。

先前所描述的分布遍及右前肺葉和右中肺葉的肺泡型的情況得到了解決。

(A)左側位可以看到右前肺葉區(qū)域可見少量非結構化的間質(zhì)型(藍色箭頭)。

整個胸內(nèi)食道仍有氣體適度擴張(白色箭頭)。

由德州農(nóng)工大學診斷影像服務提供

圖2B。

抗生素治療3周后的胸部的腹背位X線片。

先前所描述的分布遍及右前肺葉和右中肺葉的肺泡型的情況得到了解決。

由德州農(nóng)工大學診斷影像服務提供

In a prospective study of 106 dogs with various respiratory diseases and 72 healthy controls, median CRP concentrations were significantly higher in dogs with bacterial pneumonia (121 mg/L) than in those with eosinophilic bronchopneumopathy (5 mg/L), chronic bronchitis (13?mg/L), pulmonary fibrosis (17?mg/L), or cardiogenic pulmonary edema (19?mg/L).18?In another study of dogs with pulmonary parenchymal disease, CRP concentrations greater than 100 mg/L were 100% specific for bacterial pneumonia (reference interval, <10 mg/L); concentrations less than 20 mg/L reliably excluded this possibility.4?However, there was no correlation between CRP concentration and disease severity in this patient population.4

在一項前瞻性研究中，
106例患有各種呼吸系統(tǒng)疾病的犬和72例健康的對照犬，
細菌性肺炎組的犬的中位CRP濃度(121 mg/L)
顯著高于嗜酸性支氣管肺炎組(5 mg/L)、慢性支氣管炎組(13 mg/L)、肺纖維化組(17 mg/L)或心源性肺水腫組(19 mg/L)。

在另一項對肺實質(zhì)疾病犬的研究中，
CRP濃度大于100 mg/L對細菌性肺炎的特異性為100%(參考區(qū)間為10 mg/L);
濃度低于20mg /L可以可靠地排除了這種可能性。

然而，在該病患群體中，
CRP濃度與疾病嚴重程度無相關性。4

In addition to guiding decisions regarding the need for antibiotic therapy, measurements of CRP may be used to determine the duration of treatment in dogs with bacterial pneumonia. Concentrations normalize with cessation of active disease, and serial measurement of CRP may be used to confirm resolution of infection. This approach appears superior to simply extending treatment for 2 weeks beyond the resolution or stabilization of radiographic abnormalities.4,19

除了指導決定是否需要抗生素治療外，
CRP的測量還可用于確定細菌性肺炎犬的治療時間。

隨著活躍性疾病的停止，
CRP濃度恢復正常，
連續(xù)測量CRP可用于確認感染的消退。

這種方法似乎優(yōu)于單純再延長治療超出影像學異常的消退或穩(wěn)定后2周。4,19

Acute Pancreatitis

急性胰腺炎

Studies in human patients with acute pancreatitis indicate that CRP concentrations correlate with disease severity and provide useful prognostic information.20-22?In humans, severely elevated levels of CRP?(>150?mg/L)?have been used to help diagnose necrotizing pancreatitis.21?Therefore, the utility of CRP in dogs with acute pancreatitis has been of interest in veterinary medicine.

In a retrospective study of 22 dogs with acute pancreatitis treated at a veterinary teaching hospital, CRP measurements for the nonsurvivors (n = 7) were significantly higher than for the survivors (n = 15) on days 3 (68 mg/L versus 25.5 mg/L) and 4 (66 mg/L versus 16 mg/L) of hospitalization (reference interval, <7 mg/L). Persistently elevated CRP levels were also associated with a poorer prognosis in this population.11

A prospective study evaluated 2 clinical severity scores, CRP concentrations, and pancreatic lipase immunoreactivity in 13?dogs with acute pancreatitis. Interestingly, measurements of pancreatic lipase immunoreactivity were better correlated with clinical severity scores than CRP concentrations when all parameters were assessed on a daily basis.23?However, 10?of the 13 dogs in this study had concurrent diseases that may have affected CRP measurements. Larger studies are clearly needed to determine the clinical application of CRP in dogs with pancreatitis.

Immune-Mediated Diseases

Measurements of CRP have been reported in dogs with immune-mediated hemolytic anemia. As expected, concentrations were increased 25-fold at the time of diagnosis and decreased with appropriate treatment. Normalization (reference range, <8.9 mg/L) occurred in 7 of 10 surviving dogs within 2 weeks.24?However, there was no correlation between the magnitude of increase in CRP levels at the time of diagnosis and patient survival (nonsurvivors, 194 mg/L; survivors, 242?mg/L).24

Similarly, CRP concentrations are higher in dogs with immune-mediated polyarthropathy (IMPA). In a prospective study of 9 dogs with IMPA, CRP levels at the time of diagnosis ranged from 76.7 to 195 mg/L; this was markedly higher than for the 6 healthy controls (mean, <6.3 mg/L). CRP concentrations declined after initiation of immunosuppressive treatment and were significantly lower than baseline after 2 weeks.6?Importantly, CRP levels were correlated with synovial inflammation; an increase in CRP during or after treatment is therefore an indicator of relapse.6

Postoperative Infection

術后感染

Surgical procedures are associated with increased CRP concentrations in dogs. In 1 study, values increased 16- to 45-fold within 24 to 48 hours and were particularly elevated in patients undergoing orthopedic procedures associated with significant surgical trauma.25?However, CRP concentrations routinely normalized by the time of suture removal despite persistent elevations in white blood cell counts.25,26?These findings suggest that CRP is a more reliable indicator of postsurgical inflammation in patients undergoing orthopedic surgery than routine hematologic parameters.

外科手術與犬體內(nèi)CRP濃度升高有關。

在一項研究中，
在24至48小時內(nèi)，
該數(shù)值增加了16至45倍，
特別是伴有重大外科創(chuàng)傷的接受骨科手術的病患中。

然而，
盡管白細胞計數(shù)持續(xù)升高，
但CRP濃度在拆線時正?；謴驼?。25,26

這些發(fā)現(xiàn)表明，
與常規(guī)血液學指標相比，
CRP是骨科手術病患術后炎癥的更可靠的指標。

In bitches undergoing?ovariohysterectomy?for pyometra, CRP concentrations measured 4 days postoperatively were found to be higher in those with incision site infections. Affected dogs had a mean CRP concentration of 296.6 mg/L, compared with approximately 100?mg/L for the uninfected cohort.12?Measurement of CRP levels in the postoperative period may therefore provide early evidence of complications such as infection.

在因子宮蓄膿而行卵巢子宮切除術的雌性犬中，
術后4天檢測的CRP濃度在有切口部位感染的雌性犬中較高。

感染犬的CRP平均濃度為296.6 mg/L，
而未感染犬的CRP平均濃度約為100 mg/L。

因此，
術后測量CRP水平可以提供諸如感染等并發(fā)癥的早期證據(jù)。

Neoplasia?

腫瘤

Elevations in CRP concentrations have been reported in dogs with mammary tumors, lymphoma, mast cell tumors, sarcomas, and various metastatic neoplasias.8,9,26,27?In 60 dogs with mammary tumors, 77% of those with metastases had a CRP concentration above the upper end of the reference range.9?Elevations in CRP were also reported in dogs with benign and solitary tumors; an increased value is therefore not conclusive evidence of metastatic disease.9?The highest CRP levels seen in this study were found in dogs with ulcerated primary tumors (median, 114.4 mg/L).9?In a recent study evaluating dogs (N = 147) with CRP concentrations greater than 100 mg/L, 17 (12%) were found to have malignant neoplasia.28

據(jù)報道，
在患有乳腺腫瘤、淋巴瘤、肥大細胞瘤、肉瘤和各種轉移性腫瘤的犬中，
CRP濃度升高。8,9,26,27

在60例患有乳腺腫瘤的犬中，
77%的發(fā)生轉移的犬的CRP濃度高于參考范圍的上限。9

在患有良性和孤立性腫瘤的犬中也報告了CRP升高;
因此， CRP增高并不能作為轉移性疾病的結論性證據(jù)。

在本研究中發(fā)現(xiàn)，
患有潰瘍 性原發(fā)性腫瘤的犬的CRP水平最高(中位數(shù)為114.4 mg/L)。9

在最近的一項研究中，
評估CRP濃度大于100 mg/L的犬(N = 147)，
發(fā)現(xiàn)17例(12%)患有惡性腫瘤.28

In a prospective study of dogs with mast cell tumor or sarcoma, CRP levels were significantly higher (104.1?mg/L and 262.1 mg/L, respectively) in affected dogs than in healthy controls (19.7 mg/L).8?Tumor grade?did not have a significant effect on CRP concentrations.8

在一項對肥大細胞瘤或肉瘤犬的前瞻性研究中，
患病犬的CRP水平(分別為104.1 mg/L和262.1 mg/L)
顯著高于健康對照組(19.7 mg/L)。8

腫瘤分級對CRP濃度無顯著影響。8

Discospondylitis?

椎間盤脊柱炎

In humans with vertebral osteomyelitis, increased CRP concentrations are associated with shorter periods of preceding symptoms and higher mortality rates.29,30?In a retrospective study of dogs diagnosed with bacterial discospondylitis via magnetic resonance imaging, 11/18 (61.1%) had an elevated CRP concentration; this was >5 times the upper limit of the reference range in 10?dogs.16?In addition, this biomarker was more sensitive for the presence of infection than both fever and leukocytosis. Similar results were described in another study in which 14/16?dogs with imaging findings indicating discospondylitis had an elevated CRP concentration at the time of diagnosis (median, 100.7?mg/L).31?Back pain was present in all dogs; 12?were febrile but just 6/16 had a leukocytosis.31

在人類的椎體骨髓炎中，
CRP濃度升高與前期癥狀時間縮短和死亡率升高相關。29,30

在一項通過磁共振成像診斷為細菌性脊柱炎的犬的回顧性研究中，
11/18(61.1%)的CRP濃度升高;
這10例犬的CRP至少在參考范圍上限的5倍以上。

此外，
該生物標志物對感染的存在，比發(fā)熱和白細胞增多更敏感。

在另一項研究中也描述了類似的結果，
在診斷時，
14/16例的影像學結果顯示椎間盤脊柱炎的犬的CRP濃度升高(中位數(shù)為100.7 mg/L)。

所有的犬都有背痛;
12例發(fā)熱，
但僅有6/16例有白細胞增多。31

Importantly, serum CRP concentrations should be within the reference range in dogs with intervertebral disc extrusion; an elevated CRP concentration in a dog with spinal pain is therefore strongly suggestive of an inflammatory or infectious spinal condition. 27?Practitioners should bear in mind, however, that elevated CRP concentrations are also seen in patients with steroid-responsive meningitis–arteritis and is therefore not specific for discospondylitis.32

重要的是，
血清CRP濃度在椎間盤突出的犬是在參考范圍內(nèi)的;
因此，
脊髓疼痛犬CRP濃度升高強烈提示脊柱有炎癥性或感染性疾病。

然而，
從業(yè)人員應牢記，
在類固醇反應性脊膜炎-動脈炎病患中也可見到CRP濃度升高，
因此不是椎間盤脊柱炎所特有的。

How Can We Measure CRP?

我們?nèi)绾螜z測?CRP？

Several in-house systems offer CRP measurement for dogs; both the Catalyst CRP Test (IDEXX,?idexx.com) and the Canine CRP Immunoassay (Gentian,?gentian.com) have been validated for use with canine serum.33?Alternatively, samples may be submitted to major veterinary reference laboratories (e.g., Antech, Idexx), the?University of Cornell Clinical Pathology Laboratory, or the?Texas A&M Gastrointestinal Laboratory. Practitioners should contact the laboratory directly to verify?preferred sample type and shipping requirements. This analyte is stable at 22 °C (72 °F) to 4 °C (39 °F) for 14?days33; therefore, special handling or shipment on ice is not usually necessary.

一些院內(nèi)系統(tǒng)為犬提供CRP檢測;
Catalyst CRP Test (IDEXX, idexx.com)
和Canine CRP Immunoassay (Gentian, gentian.com)
均已被證實可用于犬血清。33

或者，
樣品可以提交給大型獸醫(yī)參考實驗室(例如，Antech, Idexx)，
康奈爾大學臨床病理實驗室
或德克薩斯A&M胃腸實驗室。

從業(yè)者應直接與實驗室聯(lián)系，
確認首選樣品類型和運輸要求。

該分析樣品在22°C(72°F)至4°C(39°F)下可以穩(wěn)定14天 33;
因此，通常不需要特殊處理或冰上運輸。

Results may be influenced by the specific methodology used, and reference intervals may vary between systems and laboratories. Consequently, data from different devices cannot be compared directly or used interchangeably. The same methodology should be used when assessing an individual’s response to therapy or when looking for trends.

結果可能受到所使用的具體方法的影響，
參考區(qū)間可能因系統(tǒng)和實驗室而異。

因此，
來自不同設備的數(shù)據(jù)不能直接比較或互換使用。

在評估個體對治療的反應或尋找趨勢時，
也應該使用同樣的檢查方法。

Summary 總結

Biomarkers such as CRP are likely to play an increasing role in the care of companion animals, as they provide information that may not be available with routine laboratory testing. More studies are needed to better define the role of CRP as both a prognostic indicator and a noninvasive tool for the management of dogs with a range of inflammatory diseases, but the available data suggest substantial promise. Practitioners are encouraged to become familiar with the indications for measurement of CRP levels in dogs and to consider incorporating CRP measurements into patient care protocols.

C反應蛋白等生物標志物可能在照顧伴侶動物方面發(fā)揮越來越大的作用，
因為它們提供的信息可能無法通過常規(guī)實驗室測試獲得。

需要更多的研究來更好地定義CRP作為預后指標和治療一系列炎癥性疾病的非侵入性指標的作用，
但現(xiàn)有的數(shù)據(jù)顯示了很大的潛力。

鼓勵從業(yè)人員熟悉測量犬體內(nèi)CRP水平的適應癥，
并考慮將CRP測量納入患者護理方案。

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