The Clinical Value Of Serum Procalcitonin For Acute Cholangitis

Objective:Through analysis of the data in this study, to assess the application value of serum procalcitonin (PCT) in the evaluation of both patients' condition with acute cholangitis and the clinical therapy.Methods:A retrospective analysis was performed with 70 patients suffering acute cholangitis in Shandong Dong'e people's hospital from July 2013 to December 2015. According to Guidelines for the Diagnosis and Treatment of Acute Biliary Infection formulated by the biliary tract surgery group of the Chinese medical association surgery branch in 2011, the patients were divided into acute mild cholangitis group (30 cases) and acute moderately severe cholangitis group (40 cases). By statistic analysis of the data of serum PCT, CRP, WBC, ALP, and DBIL of the patients on admission,48 h and 72 h post therapy, to obtain the average level of serum procalcitonin in the two groups of patients on admission, to compare the changes of PCT in the process of acute moderately severe cholangitis treatment, to find the changing trends of CRP, WBC, ALP, DBIL, and to explore the clinical significance of PCT for the blood culture positive patients.Results:On admission, serum PCT in patients with mild acute cholangitis increased slightly, while significantly increased in patients with moderately and severe acute cholangitis. The difference is statistically significant (P=0.000<0.05). Levels of PCT, WBC, CRP, ALP, and DBIL in the serum of patients with moderately severe acute cholangitis were retrospectively analyzed before treatment, at 48 h and 72 h post treatment. The results showed the PCT levels in serum of the moderately severe acute cholangitis group increased markedly before antibiotics treatment, while the concentration of PCT in serum fell back quickly after the patients' condition was effectively controlled. However, when the patient's condition was controlled, the decline rate of WBC, CRP, ALP, and DBIL fell back more slowly than that of serum PCT, even CRP and DBIL remained at high levels. The control measures included the use of effective antibiotics and biliary drainage. For all the patients, the serum PCT increased obviously in blood culture positive patients, while increased lightly in blood culture negative patients. The difference between the two groups is statistically significant (P=0.008< 0.05).Conclusion:It is more sensitive to monitor serum procalcitonin in acute cholangitis than CRP and WBC, which can be used as an effective clinical indicator to evaluate acute cholangitis.