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Vol. 15. Issue 1.
Pages 55-65 (January - February 2009)
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Vol. 15. Issue 1.
Pages 55-65 (January - February 2009)
Artigo Original/Original Article
Open Access
Proteína C reactiva e gravidade da bronquiolite aguda
C Reactive protein and disease severity in bronchiolitis
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S. Costa1, R. Rocha2, M. Tavares3, A. Bonito-Vítor4, L. Guedes-Vaz5
1 Interna Complementar de Pediatria, Serviço de Pediatria HSJ / Paediatrics resident, Paediatrics Department, HSJ
2 Interno Complementar de Pediatria, Serviço de Pediatria HSJ / Paediatrics resident, Paediatrics Department, HSJ
3 Assistente hospitalar de Pediatria, Serviço de Pediatria HSJ / Paediatrics consultant, Paediatrics Department, HSJ
4 Assistente hospitalar de Pediatria, Unidade de Pneumologia Pediátrica do Serviço de Pediatria HSJ / Paediatrics consultant, Paediatric Pulmonology Unit, Paediatrics Department, HSJ
5 Chefe de Serviço de Pediatria, Unidade de Pneumologia Pediátrica do Serviço de Pediatria HSJ / Head, Paediatrics, Paediatric Pulmonology Unit, Paediatrics Department HSJ
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Resumo

O diagnóstico de bronquiolite aguda é essencialmente clínico. A utilidade de exames laboratoriais, em particular do doseamento da proteína C reactiva (PCR), não está bem estabelecida.

O objectivo deste trabalho foi avaliar a relação entre o valor da PCR e os marcadores indirectos de gravidade em doentes com diagnóstico de bronquiolite.

Foram incluídos no estudo todos os doentes admitidos no Serviço de Pediatria do HSJ durante o ano de 2006 e que tiveram como diagnóstico principal bronquiolite, tendo sido feita uma revisão retrospectiva do processo clínico desses doentes.

Foram incluídos 176 doentes com idades compreendidas entre zero e 36 meses (mediana de 4 meses); 63,1% eram do sexo masculino. O doseamento da PCR tinha sido efectuado em 94,3% dos doentes, com valores compreendidos entre zero e 256mg/L e com mediana de 11mg/L.

O valor da PCR, na população estudada, apresentou uma relação estatisticamente significativa com a admissão em unidade de cuidados intensivos (UCI) (p=0,008), a duração do internamento hospitalar (p=0,025) e a necessidade de oxigenoterapia (p=0,022).

Desta forma, este trabalho coloca a hipótese de o valor de PCR poder ser um marcador de gravidade e ter significado prognóstico em doentes com bronquiolite. Mais estudos são necessários para validar estes resultados e esclarecer se existe uma relação real entre as variáveis estudadas ou se esta é produzida pelo efeito confundidor de outras infecções.

Rev Port Pneumol 2009; XV (1): 55-65

Palavras-chave:
Bronquiolite
diagnóstico
proteína C reactiva
Abstract

A diagnosis of bronchiolitis is made clinically and the use of supportive laboratory examinations, including the quantification of C reactive protein (CRP), is not well established.

The aim of this study was to evaluate the correlation between CRP value and indirect markers of disease severity in patients with bronchiolitis.

This study included the patients diagnosed with bronchiolitis admitted to the Pediatrics Department of S. João Hospital in 2006. A retrospective review was made through analysing clinical files.

176 patients aged 0 to 36 months (median of 4 months) were included. 63.1% were males. CRP level was measured in 94.3% of the patients, with values ranging from zero to 256mg/L and a median of 11mg/L.

CRP value in this population had a statistically significant relation with admission to Intensive Care Unit (ICU) (p=0.008), length of hospital stay (p=0.025) and need for supplementary oxygen during hospital stay (p=0.022).

This work raises the hypothesis that the CRP value on admission might be a marker of disease severity and have prognostic significance in patients with bronchiolitis. Further investigation is necessary to validate these results and exclude the potential confounding effect of associated infections.

Rev Port Pneumol 2009; XV (1): 55-65

Key-words:
Bronchiolitis
diagnosis
C reactive protein
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Copyright © 2009. Sociedade Portuguesa de Pneumologia/SPP
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