The Application Of Serum Procalcitonin In Elderly Community-acquired Pneumonia

Objective:Evaluation the clinical value of serum procalcitonin(PCT)in the diagnosis of elderly community acquired pneumonia bacterial infections and non-bacterial infections,study the relationship between serum PCT concentration change of the lower respiratory tract bacrerial infections and antibiotic application timing,explore the PCT guidance elderly pneumonia antibiotic therapy and optimize antibiotic use program.Methods:Choose100cases which diagnosis studied the patient’s of pneumonia in elderly patients accord with the standard community acquired pneumonia in elderly patients as the observation. clinical data collection, the general clinical data:contains the patient’s name,gender,age, underlying disease; admission and treatment clinical data: including patients’ temperature, respiration, heart rate, pulse, admission diagnosis, bacterial culture results, sputum culture, white blood count, chest X-ray, CT, antibiotic usage. It will be divided into the bacteria group (group A), the virus group (group B), mycoplasma (group C) and measured the inflammatory imarkers including PCT, CRP and WBC parameter values at the same time. Bacteria group was divided into the PCT group (Al) and control group (group A2), Al group PCT level guide antibiotic use in Al group, A2group using conventional methods treated with antibiotics in A2group. PCT guiding principles of antibiotics:when serum PCT levels≥0.5μg/L, the presence of bacterial infection, strongly recommend the use of antibiotics therapy, combined with antibiotic treatment when necessary. PCT serum levels>0.25μg/L, and<0.5μg/L, there exists the possibility of bacterial infection, it is recommended to use antibiotic treatment. Serum PCT levels of Patients<0.25μg/L,there is no possibility of bacterial infection, antibiotics are not recommended. While undergoing antibiotic treatment, it is suggested that the doctor to stop using antibiotics.Comparison group Aland A2of antibiotics use of time, clinical efficiency, hospitalization time, into severe pneumonia cases, and the determination of the first4days,7days,10days of inflammatory markers at the same time.Results:The comparison of elderly patients with community acquired pneumonia infection caused by different pathogens in Serum PCT levels:The levels of PCT in group A were significantly increase than group B and group C, Compare group A to group B, group C serum PCT concentrations relatively increased significantly, with statistical significance differences in the statistical analysis(P <0.05);Serum PCT sensitivity in the diagnosis of community acquired pneumonia in the elderly group A was87.5%, specificity of97.5%. the diagnosis of community acquired pneumonia in the elderly than the accuracy of CRP and other inflammatory markers. The changes of serum PCT since7days after the treatment,the PCT levels of0.25μg/L≤PCT<0.5μg/L being the number of patients is significantly reduced. The positive rate of group A (40%), group B (75%). The first10days after treatment, the PCT≥0.5μg/L range, A1group of patients is0people, while A2is3people. A1, A2groups after effective treatment of inflammatory indicators were lower than before treatment, A1group of antibiotic use, clinical efficiency, length of stay, the number of cases of severe pneumonia into significantly lower than the A2group, the difference was statistically significant (P<0.05)Conclusion:PCT has important clinical value in diagnosis and treatment in determining the etiology of community acquired pneumonia in the elderly, the traditional inflammatory markers CRP has high sensitivity and specificity. PCT can guide the application of antibiotics in the elderly pneumonia, it can optimize antibiotic treatment at some extent,reduce the application of antibiotics to avoid bacterial resistance. Dynamic monitoring the PCT can react the severity of infection, as clinicians provide timely changes in treatment programs based on serological, worthy of clinical application..