The Clinical Significance Of Procalcitonin In Diagnosing And Predicting The Prognosis Of Ventilator-associated Pneumonia

[OBJECTIVE] To assess the clinical significance of procalcitonin (PCT) in diagnosing and predicting the prognosis of ventilator-associated pneumonia (VAP).[METHODS] This study included 27 VAP patients, and 11 patients of them were deteriorate;the non-VAP group included 10 patients and the control group included 10 health elderly people. Serum procalcitonin, IL-6, IL-8, CRP, WBC levels were measured on days before therapy, 3 and 7 after therapy for all VAP patients.[RESULTS] On the first day, the level of PCT, IL-6, IL-8 in the VAP group was higher than non-VAP group and health elderly group. There were significant difference among the VAP group, non-VAP group and health group (P<0.01) .There was no difference between the non-VAP and health group (P>0.05 ) .The level of PCT was significantly higher from deteriorate group than relieved group,however,IL-6, IL-8 had no significant difference (P>0.05) . PCT, IL-6, IL-8 from the relieved group decreased rapidly to baseline after controlling infection. By using the receiver operating characteristic (ROC) curve, take serum PCT>1.5ng/ml on the third day as a threshold, the sensitivity, specificity and accuracy in predicting the prognosis of VAP were 82%, 90% and 0.92 respectively.[CONCLUSIONS] The results suggested that serum PCT was important for the diagnosis of VAP. PCT concentration over 1.5ng/ml as a threshold was more sensitive and specific to predict the prognosis of VAP. And the sensitivity and specificity of PCT was better than IL-6, IL-8.