Clinical Value Of PCT And CRP Levels In Community-Acquired Pneumonia

ObjectiveTo discuss the implication of procalcitonin (PCT) and c-reactive protein(CRP)in the diagnosis severity and prognosis of the Community-Acquired pneumonia(CAP).MethodsLay down strict inclusion and exclusion criteria,180cases of patients with community-acquired pneumonia hospitalized from September2009to December2012, the clinical data of patients were retrospectively analyzed.(1) According to whether the merger of sepsis, the case was divided into the sepsis and non-sepsis group. The sepsis group included simple CAP group and CAP group with chronic obstructive pulmonary disease. PCT, CRP, erythrocyte sedimentation rate (ESR), white blood cells (WBC), neutrophil percentage (N), platelet (PLT) and temperature (T) were compared between the sepsis and non-sepsis groups. APACHE II score was correlated with PCT, CRP, erythrocyte sedimentation rate (ESR), white blood cells (WBC) Using the area under the receiver-operating characteristic (ROC) curves, various inflammatory indicators were compared to differential diagnosis value of sepsis and non-sepsis group.(2) According to sepsis severity, the case was divided into the sepsis group, mild sepsis, severe sepsis, sepsis shock group. The level of PCT, CRP, APACHE II score of different guoups were compared and analyzed.(3) According to the state of CAP patients, the improvement group and no improvement group was divided. The level of PCT, CRP, APACHE II score of different guoups were compared and analyzed.Results1. The level of PCT was higher in the sepsis group than that in the non-sepsis group, presenting significant difference(P<0.01). The level of CRP, WBC, N was higher in the sepsis group than that in the non-sepsis group (P<0.05). The level of PLT was lower in the sepsis group than that in the non-sepsis group (P<0.05). The level of PLT, CRP, WBC was no statistical difference between simple CAP group and CAP group with chronic obstructive pulmonary disease (P>0.05). The level of T was no statistical difference between the three groups (p>0.05). The level of ESR was no statistical difference between the three groups (p>0.05). APACHE â…¡ score was correlated with PCT and CRP (P<0.05). The area under the PCT curve of ROC (AUC) is higher than that of CRP, WBC, N, PLT, ESR, T.2. The levels of PCT, CRP, APACHE â…¡ scores increased with the severity of the sepsis, The level of PCT was higher in the septic shock group than that in the severe sepsis group(P<0.05). The level of PCT was higher in the severe sepsis group than that in the mild sepsis group(P<0.05). The level of PCT was higher in the mild sepsis group than that in the non-sepsis group (P<0.05). The level of CRP was higher in the sepsis group than that in the non-sepsis group(P<0.05). The level of CRP was no statistical difference among different sepsis groups (P>0.05). APACHEII scores was higher in the septic shock group than that in the severe sepsis group(P<0.05). APACHEII scores was higher in the severe sepsis group than that in the mild sepsis group(P<0.05). APACHEII scores was higher in the mild sepsis group than that in the non-sepsis group(P<0.05).3. I improvement after treatment, PCT score, CRP level, APACHE â…¡ score was lower than that before the treatment level (P<0.01); Without conditions improve group before and after treatment PCT score, CRP level, there was no significant difference in APACHE â…¡(P>0.05).Conclusion1. There is a positive correlation of the level of PCT, CRP with severity of pneumonia. Illness is heavier, the level is higher, PCT is higher than that of CRP.2. PCT, CRP have certain application value in judging pneumonia complicated sepsis severity. The sensitivity of CRP is superior to that of PCT, and the specificity of PCT is better than CRP. PCT can reflect the severity of sepsis is more than CRP.3. To observe the dynamic changes of PCT level is helpful to judge the prognosis of pneumonia, especially pneumonia with sepsis. Its level is higher, the prognosis of pneumonia is worse. PCT has higher predictive value with APACHEII score of critical system.