| Background and Objective Community - aquired pneumonia (CAP) as a common suffering from acute lung infection, with the population aging ,more smoking, immune deficiency, it's mortality accounted for 10% in the world. At present, there are tow problems about CAP, that is the delay of diagnosis , particularly in the etiological diagnosis, and the inappropriate assessment about the state of CAP. Therefore, people are constantly looking for a new inflammatory marker, that could solve the two problems mentioned abovepatients on long-termMethods patients selected from the respiratory department in the Second Affiliated Hospital of Dalian Medical University since from November 2005 to August 2006. Through the clinical symptoms and X-ray, there are 96 CAP patients selected in this trial. Meanwhile designed 30 health crowd as the control group. All the patients selected in this trial had collected basic information, associated diseases, imaging examination, microbiology, blood gases analysis, and Curb-65 Score (respiratory rate, blood pressure, renal function, consciousness, age). Meanwhile, detected the values of PCT, CRP and WBC, respectively at the second day and the eight day of admission.Results1.The Comparison with Sensitivity and Specificity of PCT with CRP,WBC and ESR.According to the relevance scatterplot of these parameters, PCT has positive correlation with CRP,WBC and ESR, and the correlation coefficient respectively is 0.544, 0.364, 0.280. It demotes that thecorrelativity is CRP>WBC>ESR. In the group of CAP and health control crowd, taking the critical value of PCT, CRP and WBC respectively as 1.5μg/L,10mg/L, 10×109/L, operated received operated curve(ROC) and calculated the areas under ROC. The result respectively is 0.979, 0.831 and 0.736. PCT, the sensitivity is 0.96, the specificity is 0.90, LR+ is 0.94 and LR- is 0.07. CRP, the sensitivity is 0.64, the specificity is 0.87, LR+ is 4.9 and LR- is 0.47. WBC, the sensitivity is 0.33, the specificity is 0.93, LR+ is 4.7 and LR- is 0.72. These illustrate the value of PCT over CRP and WBC in discrimination of CAP and the health control crowd.2. The Etiologic Prognosis in CAPAmong the segregated pathogen about 31 in CAP patients, bacterial infection is 5, atypical is 24 and viral is 4, (there is 6 mixing infection). Through statistics analysis, had not statistics significant in these three groups .3. The Analysis of PCT in Assessment of Condition of CAPCalculated the value of PCT of treatment before, treatment after 8 days and health control group, the PCT median of these three groups respectively is 6.30μg/L,2.10μg/Land 0.85μg/L. Through statistic analysis, there is statistics significance between before treatment and after treatment, and between before treatment and health control crowd. But between after treatment and health control crowd, there is not statistic significant (P<0.01). Pneumonia Severity Classification (CURB-65 Score) is an objective standard for estimating the severity of the condition of pneumonia. According to this score, CAP was divided into three groups. The value of PCT respectively is 1.5μg/L,2μg/L,5μg/L as critical value, layering pneumonia into four groups (PCT<1.5μg/L(1group),1.5μg/L≤PCT<2μg/L(2group),2μg/L≤PCT<5μg/L(3group),PCT≥5μg/L(4group). Through statistic analysis, PCT corrects with CURB-65, the correlation coefficient r=0.305, P=0.003, and has different relevance in different degree pneumonia. Meanwhile the hospitalization days was calculated in the different layer, respectively is 6.50±1.20,7.70±1.20,8.70±1.20,11.20±3.50. Through statistic analysis, there is statistic significant in 1,2 group,1,3group,1,4group and 3,4 group. (P<0.05). The value of PCT indicates different degree of inflammation, and higher value of PCT grouphas the longer time in the hospital than the lower value of PCT group.Conclusion PCT as an marker of inflammation ,the sensitivity and specificity of diagnosis for CAP is higher than CRP,WBC,ESR . PCT has some degree correlation with CAP. It demotes that PCT has the contribution for doctors judging correctly and promptlyin the condition of CAP.
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