Combined Pneumonia Severity Index、Procalcitonin、C-Reactive Protein To Assessing The Value Of The Severity Of Pneumonia After Renal Transplantation

Objective:By detecting pneumonia after renal transplantation serum procalcitonin (procalcitonin, PCT), serum C- reactive protein (C-reactive protein, CRP) levels and differences in different PSI ratings level, moerover, the correlation analysis between the level of PSI score level, and study of PCT and CRP in evaluating value of pneumonia after renal transplantation infection disease severity, to perfect for pneumonia patients after renal transplantation PSI scoring system, clinicians fast, intuitive, accurate judgment of pneumonia patients after renal transplantation severity of the infection as soon as possible to determine the treatment program provides a theoretical basis.Methods:Utilise retrospective analysis of case control study method, selection in our hospital from June 2012 to December 2012, fuzhou general hospital of nanjing military command with respiratory and critical care medicine,115 patients with pneumonia after renal transplantation as experimental group and the same period in our hospital outpatient follow-up no significant complications after renal transplantation (especially infection complications) in patients with 48 cases as control group. View the experimental group respectively for the first time the original admission (before using any drugs) and control group in the clinic on the day of the determination of serum PCT and CRP level, and analysis of the level difference between the control group and the experimental group in different PSI classification, for the two levels and different PSI rating levels of the experimental group and control group to correlation analysis, ROC curve analysis.Results:(1) The different levels of experimental group and the control group of PCT and CRP levels in a statistically significant difference among these (P<0.05). The different levels of experimental group of PCT and CRP level differences within the group are also statistically significant (P<0.05).(2) Between control group and experimental group II, III PCT level difference are not significant(P values were 0.886、0.262),between the Class II and Class III PCT levels are not significant (P=0.427). While PCT level show significant differences among the Class IV, Class V and the other groups (P<0.05)(3) Significant difference are found in the control group and the different levels of experimental group of CRP levels (P<0.05) The same phenomenon also occurred in the different levels of experimental group (P<0.05).(4) No linear correlation among PCT、CRP levels and the control group in the severity of disease (PPCT=0.576, PCRT=0.861)(5) PCT、CRP levels are positively correlated with the experimental group different levels of severity PSI Rating(rPCT=0.816, rCRP=0.934,PPCT、CRP<0.05).(6) ROC curve analysis is performed in PCT、CRP levels and the different levels of experimental group and the control group, there is statistical significance due to the P values are less than 0.05. PCT、CRP levels increased with PSI rating levels, the greater both the diagnostic performance of the experimental group. The experimental of class Ⅱ level, Ⅲ level, IV level and V level of PCT、CRP cut-off point are 0.05ng/ml、0.11ng/ml、1.19ng/ml、 2.79ng/ml,16.35mg/L、61.8mg/L、117.5mg/L、171mg/L.PCT, CRP cut-off point for the experimental group to the diagnostic sensitivity are 75%、90%、95%、100%,78%、88%、 92%、100%. Specificity of these are 21%、47%、75%、98%,34%、52%、71%、97%。Conclusion:(1) It is worthy of clinical promotion that combined detection of serum PCT and CRP in the pneumonia after renal transplantation determine the severity of a higher diagnostic value.(2) Patients after renal transplantation pneumonia PCT、CRP levels increased with PSI score level rises,also to diagnostic performance, and there is a significant difference between the two levels of different ratings levels. Through cut-off point can directly reflect pneumonia after renal transplantation PSI score level, then roughly determine the severity of infection.(3)For the purposes of judgment pneumonia after renal transplantation severity, no significant difference in PCT、CRP levels.(4) It is positive correlation and sole-linear relationship exists that pneumonia after renal transplantation patients PCT and CRP levels and PSI rating system. Monitoring these can help clinicians fast, intuitive, accurate infection disease severity in patients with pneumonia after renal transplantation to evaluate and guide the use of antibiotics.