| Objective:Through detecting the level of plasma procalcitonin(PCT),interleukin-6(IL-6),C-reactive protein(CRP),cholinesterase(ChE)and N-terminal pro-brain natriuretic peptide(NT-proBNP)of elderly pneumonia patients,explore their value in the diagnosis and severity evaluation for elderly pneumonia.Methods:1.In this study,we collected 82 cases(41 males and 41 females)of elderly pneumonia patients(?65 years old)from October 2015 to January 2018 treated in the 3th Department of Respiratory in Second Affiliated Hospital of Kunming Medical University as the observation group,and collected 18 cases(11 males and 7 females)of patients(?65 years old)without recent infection and just do physical examination in our department during the same period as the control group.2.1n observation group,we collected the indexes of the gender,age,hospital stays,and the level of plasma PCT,IL-6,hs-GRP,ChE and NT-proBNP both at admission and before discharge.In control group,we collected the indexes of the gender,age,and the level of plasma PCT,IL-6,hs-CRP,ChE and NT-proBNP at admission.3.According to the group standard of guiding treatment in the auxiliary diagnosis and treatment scheme of PCT the guideline for diagnosis and treatment of community acquired pneumonia in Chinese in 2016,we divided the observation group into three groups:30 cases for PCTi group(PCT?0.25),including 14 males and 16 females,22 cases for PCT2 group(0.25<PCT<0.5),including 10 males and 12 females,30 cases for PCT3 groups(>0.5),including 17 males and 13 females.First,we compared the hospital stays of above three groups.Second,we compared the the level of plasma IL-6,CRP,ChE and NT-proBNP both at admission and before discharge in observation group.Then we ananlyzed the correlation of plasma PCT and hospital stays,IL-6,hs-CRP,ChE,NT-proBNP in PCT1,PCT2 and PCT3 group at admission.Finally we compared the the level of plasma IL-6,CRP,ChE and NT-proBNP at admission in above four groups.Results:We analyzed the indexes of gender and age of above four groups,the indexes of hospital stays of the observation group,the level of plasma IL-6,hs-CRP,ChE and NT-proBNP of the control group,the level of plasma IL-6,hs-CRP,ChE and NT-proBNP both at admission and before discharge of the observation group,we could come to these conclusion:1.The comparison of the basic information:There was no significant different in gender and age of the 18 cases of the control group and the 82 cases of the observation group(P>0.05).2.The comparison of hospital stays:There was no signifigant different in hospital stays of the PCT1,PCT2,and PCT3 group(P>0.05).3 The result of analyzing the level of plasma in the IL-6,hs-CRP,NT-BNP four groups:(1)The level of plasma IL-6,NT-proBNP of PCT1,PCT2 and PCT3 group were dramaticaly higher than those in the control group(P<0.05);(2)There were barely noticeable difference between the level of plasma IL-6,NT-proBNP in PCT1 group and PCT2 group(P'>0.017),but the level of plasma hs-CRP in PCT2 group was dramatically higher than the level of hs-CRP in PCT1 group(P'<0.017);(3)The level of plasma IL-6,hs-CRP,NT-proBNP of PCT2 group was dramatically higher than the level of IL-6 in PCT1 group(P'<0.017).(4)There was barely noticeable difference between the level of plasma IL-6,hs-CRP,NT-BNP in PCT3 group and PCT2 group(P'>0.017).4.The result of analyzing the level of plasma ChE in four groups:(l)The level of plasma ChE of PCT1,PCT2 and PCT3 group were dramaticaly lower than those in the control group(P<0.05);(2)There was barely noticeable difference between the level of plasma ChE in PCT,group and PCT2 and group(P>0.05);(3)The level of plasma ChE in PCT3 group was dramatically lower than the level of ChE in PCT,group(P<0.05).(4)There was barely noticeable difference between the level of plasma ChE in PCT3 group and PCT2 group(P>0.05).5.The result of analyzing the level of plasma IL-6,hs-CRP,ChE,and NT-proBNP in PCT1,PCT2 and PCT3 group both at admission and before diacharge:(1)The level of IL-6 in PCTi,PCT2 and PCT3 group before discharge were dramatically lower than those at admission(P<0.05).(2)The level of hs-CRP in PCTi,PCT2 and PCT3 group before discharge were dramatically lo,wer than those at admission(P<0.05).(3)The level of ChE of PCT1,PCT2 and PCT3 group before discharge were dramatically higher than those at admission.(4)The level of NT-proBNP of PCTi,PCT2,and PCT3 group before discharge were dramatically lower than those of NT-proBNP at admission.7.The result of analyzing the correlation of plasma PCT and hospital stays,IL-6,hs-CRP,ChE,NT-proBNP in PCT1,PCT2 and PCT3 group at admission:(1)There was no correlation between the level of PCT and hospital stays of PCT1,PCT2 and PCT3 group(P>0.05);(2)There were positively correlation between the level of IL-6,hs-CRP,NT-proBNP and PCT in the elderly pneumonia patients(P<0.05,the value of r were 0.435,0.475,0.325);There was negative correlation between the level of ChE and PCT in the elderly pneumonia patients(P<0.05,the value of r was 0.326)Conclusion:1.The hospital stays of the elderly pneumonia patients did't increase when the level of PCT of these patients rise.There was no correlation between the hospital stays of the elderly pneumonia and PCT in the elderly pneumonia patients.2.The level of plasma IL-6,hs-CRP and NT-proBNP in the observation group at admission were dramaticly higher than those in the control group,so the level of IL-6,hs-CRP and NT-proBNP have an importantly clinical significance in diagnosis of pneumonia in the elderly.3.The level of plasma IL-6,hs-CRP,NT-proBNP in PCT3 group were dramatically higher than those in PCT1 group,and there was barely noticeable difference between those in PCT3 group and PCT2 group.There was barely noticeable difference between the level of IL-6,NT-proBNP in PCT1 group and PCT2 group,the level of hs-CRP of PCT2 was higher than the level of hs-CRP in PCT1 group.There were positively correlation between the level of IL-6,hs-CRP,NT-proBNP and PCT in the elderly pneumonia patients,so the level of plasma IL-6,hs-CRP and NT-proBNP can reflect the severity of illness to some extent.4.The level of plasma ChE in the observation group at admission were dramaticly lower than the control group,so the level of ChE have an importantly clinical significance in diagnosis of pneumonia in the elderly.5.The level of plasma ChE in PCT3 group are dramatically lower than those in PCT1 group,and there was barely noticeable difference between those in PCT3 group and PCT2 group.There was barely noticeable difference between the level of ChE in PCT1 group and PCT2 group.There was negative correlation between the level of ChE and PCT in the elderly pneumonia patients,so the level of ChE can reflect the the severity of illness to some extent.6.The level of plasma IL-6,hs-CRP and NT-proBNP in elderly pneumonia patients before discharge were dramaticly lower than above these indexes at admission.The level of plasma ChE in elderly pneumonia patients before discharge were dramaticly higher than at admission.As a sensitive marker of pneumonia in the elderly people,above these indexes can be used to monitor disease and access the effect of treatment.7.The limitation of this study:(1)the sample of the study is small,we will further expand the sample size,refine the scope of the study in later period;(2)the study belongs to retrospective study,the above indicator were reviewed twice,but we can't keep the same time interval of double-check. |
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