The Clinical Study Of Procalcitonin Detection In The Fever Patients With Malignant Hemotologic Disease

Objective The aim of this study was to explore the value of procalcitoninin the infected patients with malignant hemotologic disease, early to judge theseverity of infection and provide the basis for the treatment.Methods All adult patients who were admitted into Blood medical wardof Affiliated Hospital of Ningxia Medical University between January1st,2010and July30th,2011.According to etiology, radiographic, symptom and signs, allpatients were divided into the infection and those with fever of unknown origin. Inthe infection group, these patients also were divided into the group with amicrobiologically documented infection and those with a clinically documentedinfection. Serum procalcitonin concentrations were measured by an immunoassayon the moment when patients were fevered. Then, accessing the difference ofprocalcitonin’s level between the infection and those with fever of unknown origin.If the procalcitonin’s level was related with the underlying diseases, the degree offever and grade of neutrophic/white blood cell count.Result With117fever patients of malignant hemotologic disease, therewere no significant difference between the degree of fever and the underlyingdisease. However, procalcitonin level has the statistically significant differencebetween the infection and those with fever of unknown origin(χ~2=14.045，P=0.01).And, there wasn’t significant difference between the blood culture positive and thenegative. Among the group with a microbiologically documented infection, thosewith a clinically documented infection and those with fever of unknown origin, the PCT levels were significantly different(χ~2=14.940， P=0.004). On the other hand,no statistical significance was found between culture-positive and negative attacks(χ~2=0.418， P=0.887)or between Gram-positive bacteria and Gram-negativebacteria(χ~2=1.677， P=0.489). Clear diagnosis of infections, there wasn’tsignificant difference among different groups divided by the leukocyte count. Theinitial PCT levels in the fever patients haven’t relationship.Conclusions1, In the fever patients with malignant hemotologic disease,procalcitonin values are not affected by the underlying diseases, the degree offever and the grade of neutrophic/white blood cell count.2, In the fever patientswith malignant hemotologic disease, procalcitonin was helpful to diagnosticinfection.3, In the bacterial infections, PCT levels could not distinguish betweenculture-positive and negative attacks or between Gram-positive bacteria andGram-negative bacteria infection.4, In the fever patients with malignanthemotologic disease, PCT levels were found to be elevated when the infectionworsened.5, PCT concentration is independent with the prognosis of patients，when determined on the initial fever.