The Correlation Discussion About The Level Of Serum Procalcitoninin With The Change Of Serum Prealbumin And Inflammatory Biomarkers In Community Acquired Pneumonia Patients

Objective:Exploring the changes of the levels of serum prealbumin(PAB),inflammatory biomarkers high sensitive C-reactive protein(hs-CRP),peripheral blood white blood cells(WBC),neutrophils(NEU),and the percentage of neutrophils(NEU%)in Community acquired pneumonia(CAP)patients with different levels of serum procalcitonin(PCT),analysising their correlation,observing and comparing the serum PAB between on admission and after treatment,discussing the application of serum PAB in CAP patients.Methods:In this study,we random collected 336 cases of the hospitalized CAP patients treated in the Respire Department of the Second Affiliated Hospital of Kunming Medical University from September 2015 to January 2018 as research subjects.They are divided into group A,group B,group C,and group D according to their serum PCT values on admission.The PCT<0.1ng/ml in group A,0.1ng/ml<PCT<0.25ng/ml in group B,0.25ng/ml≤PCT<0.5ng/ml in group C,PCT≥0.5 ng/ml in group D.We gathered the age,the gender and the Body Mass Indx(BMI)and detected the level of serum PAB,hs-CRP,peripheral blood WBC,NEU and NEU%when the four groups patients on admisson.We observed the correlation of the serum PAB with the other indicators.After treantment,we retested the serum PAB and compared the value of serum PAB on admission with the value after treatment in each group,analysised and compared the changes of the serum PAB among four groups.All the statistical analysis of results were done by the SPSS 17.0 statistical software.Results:1 There is no statistical significance in gender,age and BMI among the four groups.2 The levels of the serum PAB(mg/L)in group A(215.47±53.98),group B(187.12±55.49),group C(133.37± 52.14)and group D(102.14±43.62)show a downward trend.There is statistical significance in the value of serum PAB among the four groups(P<0.05).The levels of serum hs-CRP(mg/L)in group A(7.42± 19.97),group B(25.86±52.63),group C(63.13±91.73)and group D(106.61 ±92.27)show an upward tendency.There is statistical significance in the value of serum hs-CRP among the four groups(P<0.05).The levels of NEU(%)in group A(65.00±18.507),group B(25.86±52.63),group C(81.80±17.25)and group D(71.30±15.33)show an upward tendency.There is statistical significance in the value of peripheral blood NEU%among the four groups(P<0.05).The levels of WBC(×109/L)in group A(6.78±2.96),group B(7.02±5.17),group C(8.53±4.69)and group D(8.11±7.15)show an upward tendency.There is statistical significance in the value of peripheral blood WBC between group A and group C,group A and group D,group B and group C,group B and D(P<0.05).There is no statistical significance in the value of peripheral blood WBC between group A and group B,group C and group D(P>0.05).The levels of NEU(×109/L)in group A(4.18±2.28),group B(5.17±4.11),group C(6.67±5.75)and group D(8.11 ±7.15)show an upward tendency.There is no statistical significance in the value of peripheral blood NEU between group A and group B(P>0.05),but there is statistical significance when coparing any two groups of the rest(P<0.05).There is no statistical significance in hospital stays among group A、group B and group C(P>0.05).There is statistical significance in hospital stays coparing group D with group A,group B and group C(P<0.05).3 For CAP patients,the serum PAB is strong inverse correlation with the serum PCT(r=-0.678)and hs-CRP(r=-0.656),moderate inverse correlation with the peripheral blood NEU%(r=0.437),and weak inverse correlation with the count of peripheral blood WBC(r=0.223)and NEU(r=0.313),and the hospital stays(r=-0.318).For CAP patients,the serum PCT is strong positive correlation with the serum hs-CRP(r=0.612),moderate positive correlation with the peripheral blood NEU%(r=0.550)and the count of NEU(r=0.417),and weak positive correlation with the count of peripheral blood WBC(r=0.319)and the hospital stays(r=0.217).4 After treatment,the levels of serum PAB in four groups have a rising,the changes of group C and group D are more than group A and group B.There is statistical significance between the serum PAB on admission and afteer treatment in each group(P<0.05).There is no statistical difference in the change of the serum PAB comparing group A with group B,group C with group D(P>0.05).There is statistical difference in the change of the serum PAB comparing group A with group C,group A with group D,group B with group C,group B with group D(P<0.05).Conclusions:1 For CAP patients there is strong inverse correlation between the serum PAB and the serum PCT,both of them have the same correlation intensity with the peripheral blood WBC,hs-CRP,NEU,and NEU%.The levels of serum PAB and peripheral blood WBC,NEU and NEU%are normal,the levels of serum hs-CRP have a certain degree of rise,when the serum PCT<0.25ng/ml considered no bacterial infection.The level of serum PAB is significantly lower than the normal reference range,the value of serum hs-CRP,peripheral blood NEU and NEU%increased significantly,the level of peripheral blood WBC is higher than the patients considered no bacterial infection,but it’s still in the the normal reference range,when the serum PCT≥0.25ng/ml considered bacterial infection.After treatment,the serum PAB has a certain degree of increase for all CAP patients,the patients who the serum PCT≥0.25ng/ml considered bacterial infection change more.It’s considered that the serum hs-CRP and the count of peripheral blood WBC increased in CAP patients consider bacterial infection,but they are lack of specificity.The serum PAB,The count of peripheral blood NEU and NEU%are the same as the serum PCT have high specificity to the change of bacterial infection,can be used as important reference for evaluating pathogens and choosing antimicrobial in CAP patients.2 To some extent,the serum PAB and serum PCT can reflect the prognosis and illness of the patients with CAP.When the serum PAB lower and the serum PCT higher,the hospital stay is longer.