The Clinical Value Of C-reactive Protein And D-dimer In Elderly Community-acquired Pneumonia

Objective This research investigates the diagnostic value and the order of severity judgment of C-reactive protein (CRP), the D- dimer (DD) in elderly community acquired pneumonia (CAP) through measurement their serum levels,So we can judge the condition the weight degree, choose treat the place early as well as determine prognosis.Methods Collects clinical data of 100 example old age CAP patient (case group), and according to the CURB-65 point scale divides them into three groups, while random selection outpatient service physical examination's old age healthy persons 60 examples (control group), All the case group patients and the control group persons were extracted peripheral blood serum within 24 h in early morning hollow,and separated. Examination Examination the CRP uses the emulsion immunity turbidimetric method. CRP normal upper limit is 8 mg/L. Examination the D- dimer uses the immunity turbidimetric method, the normal upper limit is 400ug/L. Meanwhile examines white blood cell(WBC), Erythrocyte sedimentation rate (ESR) with conventional method. And discusses the relations beteen CRP, DD and clinical of indexes.Results 1.CRP, DD and WBC, ESR sensitivity and specificity comparison:in 100 cases, CRP> 8 mg/L 92 cases;DD> 400ug/L 62 examples; WBC>10×109/L62 examples;ESR masculine>15mm/h, feminine>20mm/h altogether 61 examples, the positive rate respectively is 92%,62%,62%,61%. For CRP, DD, WBC, ESR,the sensitivity respectively is 92%,62%,62% 61%;the specificity respectively is 88%, 84%,30%,25% for the elderly CAP diagnosis. The sensitivity of CRP surpasses DD,WBC, ESR in diagnosis the elderly CAP, the statistic differences were obvious(p<0.05); the specificity of CRP,DD surpasses WBC, ESR in the elderly CAP, the statistic differences were obvious(p<0.05).2.The levels of CRP,DD in the case group are higher obviously than the control group, the statistic differences were obvious(p<0.05). Relevant scatter diagram of CRP and DD demonstrates that there is relevance between CRP and DD (r=0.58, p<0.05)3.The CRP,DD level comparison in different CURB-65 group has statistically difference (P<0.05),And the CRP, DD level advances along with the pneumonia order of severity advances, but the WBC, ESR do not have statistically difference during each group (P>0.05).4.Relationship between CRP and each clinical index:There were no statistics difference in CRP levels between <75y and≥75y groups; male and female groups; temperature≤38.5℃and 38.5℃groups; urea nitrogen≤7.1mmol/L and >7.1mmol/L groups (P>0.05).However,Circulation failure patients CRP levels are higher than no circulation failure patients; Consciousness obstacle patients CRP levels are higher than no Consciousness obstacle patients); Respiratoryfailure patients CRP levels are higher than no respiratory failure patients;The patients with multi-lobe damages on lung CRP level obviously is higher than the single leaf, section pneumonia patients, the differences were statistically significant(P<0.05)5. Relationship between DD and each clinical index:There were no statistics difference in DD levels between men and women groups;temperature≤38.5℃and >38.5℃groups (P>0.05); However, DD levels in group≥75y are higher than<75y group; in circulation failure group are higher than no circulation failure group; in consciousness obstacle group are higher than in no Consciousness obstacle group; in respiratory failure group are higher than in no respiratory failure patients; in group of urea nitrogen≤7.1mmol/L are higher than >7.1mmol/L group; in multi-lobe pneumonia group are higher than in the single leaf, section pneumonia group, the differences were statistically significant(P<0.05).Conclusion CRP, DD levels on elderly CAP have diagnostic significance in elderly CAP, and CRP, DD levels have certain correlation with the severity of the elderly CAP, CRP levels have some connection with the elderly CAP with circulation, consciousness, respiratory, inflammation area. DD levels have some connection with the elderly CAP of the patient's age, circulation, consciousness, breathing, urea nitrogen,inflammation area. Can be used as judge severe index, but also as a therapeutic effect evaluation index. In clinical for elderly CAP in a timely, accurate treatment and prediction of prognosis provide reliable basis.