The Clinical Value Of PCT, CRP And CPIS Score In Ventilator Associated Pneumonia

Objective To investigate the clinical value of PCT,CRP and CPIS score in the treatment of ventilator-associated pneumonia(VAP),and to explore the correlation between serum PCT,CRP and CPIS.Methods From June 2013 to June 2016 in the First Affiliated Hospital of Guangzhou medical university hospital emergency ICU patients in 633 cases,which required mechanical ventilation in patients with 435 cases,were retrospectively analyzed after 187 patients with ventilator-associated pneumonia.The blood,PCT,CRP and sputum culture were collected,and the clinical pulmonary infection(CPIS)score was observed.The relationship between various factors and VAP was analyzed,and the prognosis was analyzed.Statistical methods SPSS19.0 is used for statistical analysis,count data to rate(%),measurement data with (?)±s,were compared by t test,count data set compared with the χ2 test,multivariate analysis using multivariate linear regression analysis,the prognosis of the patients was evaluated using the Log Rank test group,P < 0.05 that is statistically significant difference.Results(1)Among the 187 patients with VAP,103 were male and 84 were female.The average age was 46-101 years 65 + 12.5 years,and the course of disease ranged from 6 months to 7.5 years.According to sex,age,course of disease,basic cause of disease and CPIS score classification,the distribution of VAP in each group is shown in Table 3 and figure 1 and figure 2.(2)With the 187 patients with VAP,we found that there were PCT positive in the plasma of 159(85%)patients(0.5ug/L),and plasma CRP was positive in 167(89.3%)patients(>10mg/L).According to the type of infection,infectious bacteria classification,each group of plasma PCT,no statistically significant differences in serum levels of CRP(P>0.05),with 6 points as the boundary points,according to the CPIS standard for evaluation of VAP patients group after statistical analysis.The results showed that CRP and PCT levels,compared with the ≤6 group,CRP group of patients is less than or equal to 6 and the level of PCT increased significantly,the difference was statistically significant(P<0.05).(3)The CPIS score was the independent variable,and the other indicators were dependent variables.It was found that the level of CPIS was linearly related to the levels of PCT,and the correlation coefficients were r(PCT),=0.94,r(CRP),=0.86,P<0.05.(4)In the 187 patients with VAP were enrolled according to the CPIS score of >6 and less than or equal to 6 divided into different boundaries,statistical survival of patients within 60 weeks,the results showed that CPIS is less than or equal to 6 points.The survival rate was significantly higher than >6 points.X2=8.588,P=0.003.Conclusion:(1)combined evaluation of PCT,CRP and CPIS scoring has certain effect on early identification of ventilator associated pneumonia,but it can not predict the type of infection and pathogenic bacteria.(2)the CPIS score is associated with the survival rate of ventilator associated pneumonia,which can provide a reference for the clinical survival of VAP patients.