Analysis Of Procalcitonin Level Detection Results Of Patients With Severe Pneumonia

Objective: The current severe pneumonia is a common severe disease of respiratory medicine. It has the clinical features of diversification and complication. The patient’s condition often progress rapidly involving the viscera functions and has high fatality rate. However, the etiology culture takes long and has low positive rate which makes the early pathogen difficult to diagnose, which often delay effective treatment time and has poor prognosis. This study aims to monitor the levels of procalcitonin(PCT), hypersensitive C-reactive protein, hs-CRP, erythrocyte sedimentation rate(ESR), white blood cell count(WBC) of the patient and combines the result of etiology to further explore and analyze the application value of the identification of valcalcitonin in severe pneumonia for the reference of future clinical diagnosis and treatment.Methods:1 Collect the 144 patients with severe pneumonia respiratory medicine in the East Branch of The Second Hospital of Hebei Medical University from November 2013 to July 2014. All the patients have complete physical examination and imaging data(chest X-ray, chest CT) according to the criteria. After admission, the patients should have examinations of etiology examination, virus series, measurement of respiratory pathogens, blood culture, fungi G test send sputum culture and smear, etc. The patients who were fasted for more than 12 h should have the examinations of procalcitonin, blood routine examination, blood sedimentation and hypersensitive c-reactive protein at 7:00 the next morning after admission and have a re-examination on the 7th day. According to the result of etiology research after admission, the participants were divided into three groups: bacterial infection group(89 cases), fungal infection group(21 cases) and viral infection group(34 cases). Then, they were divided into improving group(136 cases) and prognosis(8 cases) after treatment.Through the analysis the data of all research objects, to explore calcitonin original(PCT) and hypersensitive c-reactive protein(hs-CRP) erythrocyte sedimentation rate(ESR) and white blood cell count(WBC) level change in severe pneumonia, and different treatment in severe pneumonia microbial identification application value and prognosis of disease. For future clinical diagnosis and treatment work to provide a simple and effective observation index.2 The detection of Blood samplesPCT levels of procalcitonin testing instruments using upconversion luminescence immunity analyzer and original kit.This kit using double antibody sandwich immunochromatography,Test,the patients’ whole blood and dilute the droplets into the test card sample hole, Then will detect card insertion turn Upconversion luminescence measured immune analyzer, You can read from the instrument to measure the levels of sample PCT. Serum hs-CRP using particle-enhanced immunoturbidimetric method,applies the German BAYER 1650 full automatic biochemical analyzer. Routine blood, blood sedimentation test using whole blood specimens sented to Clinical laboratory in the second hospital of hebei medical university,Is operated by professionals.3 Date collection Design the forms of research data and collect general information of the patients(date of birth, gender, profession, etc.), biochemical indicators(PCT, routine blood test, C-reactive protein and blood sedimentation, etc.), medical history and outcome in 7days after discharge.Results 1.The levels of PCT in bacterial infection group were significantly higher than that in fungal and viruses infected groups(P <0.05). The levels of WBC,ESR and logarithmic transformation of hs-CRP, had no significant difference(P > 0.05). The mean level of PCT in bacterial infection group, fungal infection group and viral infection group was(1.91 ± 2.7)ng / m L,(0.56 ± 0.69)ng / m L and(0.11 ± 0.1)ng / m L respectively, the difference was statistically significant,(P<0.05). The mean level of hs-CRP in bacterialinfection group, fungal infection group and viral infection group was(1.74 ± 0.28) mg / L,(1.64 ± 0.55)mg / L, and(1.62 ± 0.6)mg / L respectively. The mean level of WBC in bacterial infection group, fungal infection group and viral infection group was(12.45 ± 4.84) × 109 / L,(11.49 ± 1.45) × 109 / L, and(8.77 ± 1.53) × 109 / L respectively. The mean level of ESR in bacterial infection group, fungal infection group and viral infection group was(51.16 ± 35.22)mm / h,(48.56 ± 25.33)and(47.48 ± 29.69)mm / h respectively.2 The level of PCT in bacterial infection group was decreased significantly after the treatment(1.91 ± 2.7,0.8 ± 2.22) ng / m L, The difference was statistically significant,(P <0.05).3 Univariate Logistic regression analysis showed that bacterial infection is the risk factors in affecting the level of PCT> 0.25 ng / m L, RR= 19.29(95% CI is 7.10- 52.42);4 The levels of PCT, hs-CRP and WBC in improved group were lower than poor prognosis group, the differences were statistically significant,(P <0.05).Conclusion:1 The original levels of procalcitonin in bacterial infection group are higher than that of fungal infection and virus infection group which prompt procalcitonin can be used to distinguish between bacterial lung infection and bacterial infection. That can be used as a basis for the clinical application of antibiotics. Allergic reactions protein level, determination of erythrocyte sedimentation rate and the value of white blood cell make little contribution to distinguish different pathogen infection.2 PCT is an effective observation index response to bacterial infection of severe pneumonia severity and outcome.3 The bacterial infection is the risk factors which influence the PCT level.