Changes Of Procalcitonin And CRP In Peripheral Blood Of Patients With Pneumocystis Pneumonia After Renal Transplantation

Objective: to evaluate the effect of PCP on plasma procalcitonin and CRP by measuring plasma procalcitonin and CRP in patients with PCP.To explore the value of early detection of plasma procalcitonin and CRP in differentiating Pneumocystis pneumocystis pneumonia from bacterial pneumonia after renal transplantation.Methods: A retrospective study of our hospital between January 2012 and June 2018,55 cases of cough,fever after renal transplantation,with or without chest tightness,or difficulty breathing patients in the hospital as the research object,all patients were diagnosed or clinical diagnosis of PCP.Pneumocystis pneumocystis were found in sputum(including induced sputum)and bronchoalveolar lavage fluid(BALF)for the diagnosis of PCP,according to the typical imaging changes of clinical symptom host factors.Clinical anti-Pneumocystis treatment is effective for clinical diagnosis of PCP.All patients were treated with procalcitonin and procalcitonin in peripheral blood immediately after admission CRP test showed that procalcitonin concentration less than 0.5ng/mL was normal,0.5-2ng/mL was suspicious positive,2ng/mL was positive,CRP concentration ? 10mg/L was normal,10-50mg/L indicated slight increase.50-100mg/L showed slight elevation,and ? 100mg/L was severe.At the same time,the data of sex,age and onset time after renal transplantation were collected to describe and express.First,the data of PCT and CRP in 55 patients were tested for normality,and the normal distribution data were expressed as mean ± standard deviation,non-normal score.The distribution data were expressed as the median(quartile spacing),and whether the mean or median was different from the normal value;The data of procalcitonin in peripheral blood and CRP were compared betweenthe two groups.According to the results of normality test,the results were analyzed by single factor ANOVA or rank sum test.Then the data of procalcitonin and CRP between the two groups were described according to the results of statistical calculation.Results: The data of procalcitonin and CRP were indicated to be skewed distribution data by normal test,so the median and quartile numbers were used to describe the data.The difference between groups was compared by rank sum test.The median value of total plasma procalcitonin concentration in 55 patients with PCP was 0.16(0.10 ±0.41)pg/ml,There was no significant change(normal value less than 0.5pg/ml)(P > 0.05),CRP).Median concentration of mg/L,was 38.3(14.8-49.2).Mg/L,was slightly higher than normal(normal value was less than 10mg/L)(P).< 0.05)The median of plasma procalcitonin concentration in the confirmed group was 0.1(0.0925)0.16 pg/ml,CRP concentration was 28.05(5.91-43.67)mg/L..The median of plasma procalcitonin concentration in the clinical diagnosis group was 0.177(0.1 ±0.42)ng/ml,CRP = 39.35(19.92-49.7)mg/L..The plasma procalcitonin and CRP levels in the clinical diagnosis group were higher than those in the diagnosed group,but there was no significant difference between the two groups(P > 0.05).The general data of Pneumocystis infection diagnosis group and clinical diagnosis group after renal transplantation were compared.There were 12 males and 7 females in the confirmed group.The median age(quartile spacing)was 34.50(30.25 ~ 42.25)years old.The median onset time(quartile spacing)of PCP was 118(97.5 ~ 161.5)days after renal transplantation.Nine cases were diagnosed by bronchoalveolar lavage fluid(BALF),)in10 cases by inducing sputum to detect Pneumocystis.Of the 36 patients in the clinical diagnosis group,25 were males and 11 females,with a median age of 31.50(26.75 /38.2)5)the median onset time of PCP was 99(87.5 ~ 147)days after renal transplantation.There was no significant difference in age,sex and other general data between the two groups(P > 0.05).Conclusion: there was no significant change of procalcitonin in peripheral blood of PCP patients in the early stage,but the CRP index was slightly increased.The levels of procalcitonin and CRP in peripheral blood of patients with bacterial pneumonia increased significantly.This suggests that procalcitonin and CRP may be useful in differentiating PCP from bacterial pneumonia after renal transplantation.