Relationship Between Pneumoconiosis With Infection And Lower Airway Bacterial Colonization And The Diagnostic Value Of C-reactive Protein And Procalcitonin

Objective: To investigate the relationship between lower airway bacterialcolonization(LABC)and pneumoconiosis with acute lower respiratory infection(hereinafter referred to as “pneumoconiosis with infection”),and the diagnostic value of procalcitonin(PCT)and C-reactive protein(CRP).Methods: The 45 patients who were diagnosed with pneumoconiosis had received sputum bacteria culture,lung function,PCT,CRP tests both in a stable phase and when having pneumoconiosis with infection.The positive rate and strain of sputum bacteria culture,changes in lung function,the positive rate and concentration of PCT,CRP were compared between the two groups,as well as compared with health contrast group.Results: 1.Quantitative sputum bacteria of pneumoconiosis in a stable phase was ?107 CFU/ml in 14 patients(31.11%),which indicated the presence of LABC,haemophilus influenza and streptococcus pneumonia accounting for the biggest proportion.And no pathogenic bacteria detected with healthy controls.2.Compared with no LABC group,there are LABC group of patients in pneumoconiosis infection of lower respiratory tract bacterial infection rate increased significantly(85.71%),of which the differences were statistically significant(?~2 = 11.0293,P < 0.01).And there are 9 patients in stabilization and acute infection period,check out the same flora bacteria homologous rate was 40.91%.3.In the LABC group,FEV1 and FEV1/FVC of patients with pneumoconiosis with infection was higher than that of non-LABC group,of which the differences were statistically significant(P < 0.001);And in the follow-up of 1 year LABC higher FEV1 changes and the number of exacerbations in patients with no LABC group,the difference was statistically significant(P<0.01,P < 0.05).4.Whether or not there are LABC,follow-up of 1 year average FEV1 decline in lung function level and average number of exacerbations correlation study shows that both were positively correlated(r=0.844,P < 0.001).5.The PCT value and CRP value of the pneumoconiosis with infection group were significantly higher than those of stable pneumoconiosis group and health contrast group,of which the differences were statistically significant(P < 0.001);the PCT value and CRP value of LABC group was higher than that of non-LABC group,of which the differences were statistically significant(P < 0.01,P < 0.05);while the comparison of PCT value and CRP value of stable pneumoconiosis group and those of health contrast group indicated no statistical significance(P > 0.05).6.The PCT sensitivity was higher than CRP sensitivity,with no statistical significance(?~2 = 2.0,P > 0.05);the PCT specificity was higher than CRP specificity,with statistical significance(?~2 = 4.4056,P < 0.05).Conclusion: Some patients with pneumoconiosis complicated with LABC or bacterial colonization may develop lower respiratory infection due to increased bacterial amount and airway inflammatory response,make the occurrence of acute aggravating illness.And LABC can increase the number of exacerbations in patients with pneumoconiosis disease so that the lung function decline further.Whether or not there are LABC,pneumoconiosis patients were followed up for 1 year FEV1 average decline in lung function and the average number of exacerbations were positively correlated.In pneumoconiosis disease of acute infection of PCT and CRP has certain diagnostic value,and the diagnostic value of calcitonin original and more specific.