The Value Of Kreds Von Den Lungen-6 And Procalcitonin In Community-acquired Pneumonia

Objective:To explore the value of Kreds von den Lungen-6(KL-6)and procalcitonin(PCT)in the early diagnosis,evaluating the severity and prognosis of community-acquired pneumonia(CAP)Methods: from January 2017 and December 2017,129 patients with adult CAP were enrolled in the Department of Respiratory Medicine and Critical Care Medicine of the First Affiliated Hospital of Hebei North University.All patients with CAP were eligible category to one with that of the diagnostic criteria established by the “Guidelines for the Diagnosis and Treatment of Community Acquired Pneumonia in Adults in China”.(2016 edition).In the same period,67 healthy subjects from our physical examination center were collected as the control group.According to the PSI score,the patients were divided into the low risk group,medium risk group and high risk groups;According to the diagnostic criteria of severe pneumonia,All patients were divided into severe CAP group and non-severe CAP group;According to the patient’s discharge situation,they were divided into the death group and the survival group.Differences in white blood cell count(WBC),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),procalcitonin(PCT),and Kreds von den Lungen-6(KL-6)were compared between groups,the spearman correlation analysis is used to analyze the relationship between KL-6,PCT,CRP,ESR,WBC and PSI score,and KL-6 correlation with PCT,CRP,ESR,WBC,the receiver operating characteristic curve(ROC)is used to analyze each biomarker of The ability to predict the risk of death in patients of CAP.Results: The levels of KL-6,PCT,CRP,ESR and WBC in CAP patients were significantly higher than those in healthy controls(all P<0.05).According to the PSI score group,there were 79 cases(61.24%)of the low risk group,34 cases(26.36%)of the medium risk group,and 16 cases(12.40%)of the high risk group,the indicators were statistically different among three groups(all P<0.05).There were 115 cases(89.15%)of non-severe CAP and 14 cases(10.85%)of severe CAP.The levels of serum KL-6,PCT,CRP,ESR and WBC of patients of severe CAP were significantly higher than those in patients of non-severe CAP(all P< 0.05).According to the patient’s discharge situation,119 cases(92.25%)of survivor,and 10 cases(7.75%)of death.The levels of serum KL-6,PCT,CRP,ESR and WBC of patients with death CAP were significantly higher than those of surviving CAP patients(all P< 0.05).KL-6,PCT,CRP,ESR,WBC and PSI scores were positively correlated(r=0.744,0.685,0.661,0.578,0.537,P<0.05),KL-6,PCT,CRP and the PSI scores were strongly correlated,ESR and WBC were moderately correlated with the PSI scores.KL-6 was positively correlated with PCT,CRP,ESR and WBC(r=0.766,0.571,0.562,0.479,P<0.05),KL-6 was strongly correlated with PCT and CRP,and KL-6 was moderate correlated with ESR and WBC.The area under receiver operating characteristic curve(ROC)of KL-6,PCT,CRP,ESR,and WBC were 0.897,0.930,0.818,0.789,and 0.742,respectively.Conclusion:KL-6 and PCT have value in the diagnosis,judgment of the severity and prognosis of CAP.KL-6 is positively correlated with clinically used biomarkers,indicating that KL-6 will become a new biomarker for clinical use.