Study On Clinical Value Of Combined Detection Of Multiple Inflammatory Markers In Respiratory Tract Infection

ObjectiveTo explore the reasonable selection and combined detection of inflammatory markers such as procalcitonin(PCT),high-sensitivity C-reactive protein(hs-CRP),serum amyloid A(SAA),prealbumin(PA),immunoglobulin(GLB),erythrocyte sedimentation rate(ESR),brain B-type natriuretic peptide(BNP)white blood cell(WBC)analysis in diagnosis of diseases of respiratory tract infection MethodsThe data of the 1276 selected cases in four tertiary hospitals in Guangdong province were collected and analyzed,including sex,age,clinical features,diagnosis,laboratory examination of common inflammatory indicators,bacterial culture,virus screening,etc.To analyze the distribution characteristics of WBC?hs-CRP?SAA and other clinical inflammatory markers and the diagnostic performance in bacterial or viral infection in respiratory tract infection.Then the depth exploration study was conducted to analyze the clinical value of combined detection of several classical and novel inflammatory markers such as PCT?ESR?PA?GLB?BNP,etc.in 244 inpatients of Fangcun hospital of Guangdong provincial hospital of traditional Chinese medicine.And then 150 cases were collected to verify the results.ResultsIn bacterial infection and viral infection,the P values of various clinical inflammatory markers in different sexes were>0.05,and the difference was not statistically significant.The SAA and hs-CRP increased significantly in the elderly group,but there was no statistical difference between the WBC groups.WBC,hs-CRP and SAA were significantly increased in bacterial infection,and SAA and SAA/hs-CRP increased significantly in viral infection,and the amplitude of SAA in bacterial group and viral group was significantly higher than that in hs-CRP?PCT?ESR and BNP in patients with respiratory tract infection increased significantly,PA decreased significantly,and the change of GLB was not statistically significant.WBC has a definite diagnosis of bacterial and viral infection,and the diagnostic performance of SAA/hs-CRP is poor,and the diagnostic performance of hs-CRP,SAA,or a combination of several indicators is higher.Judgement on the infection of the bacterial,the best advice is the WBC+SAA+hs-CRP,followed by WBC+hs-CRP and WBC+SAA.The models are as follows.WBC+SAA+hs-CRP : logitP=8.603-0.627 × WBC-0.490 ×hs-CRP-0.023 × SAA;WBC+hs-CRP : logitP=8.561-0.665 × WBC-0.559 × hs-CRP;WBC+SAA:logitP=6.290-0.497×WBC-0.061×SAA.Judgement on the infection of the virus,the best advice is WBC+SAA+hs-CRP+SAA/hs-CRP,followed by WBC+SAA+hs-CRP ? WBC+hs-CRP and WBC+SAA.The models are as follows.WBC+SAA+hs-CRP+SAA/hs-CRP : logitP= 3.642-0.370 × WBC-0.073 ×hs-CRP-0.025×SAA-0.003×SAA/hs-CRP;WBC+SAA+hs-CRP:logitP= 4.676-0.371×WBC-0.232×hs-CRP-0.022×SAA;WBC+hs-CRP:logitP= 4.551-0.390×WBC-0.319×hs-CRP;WBC+SAA:logitP= 4.404-0.358×WBC-0.038×SAA.SAA as viral and bacterial infections are closely related factors,combined with WBC and hs-CRP in bacterial infection group judgment coincidence rate can reach 95.1%,the virus infection group,correct detection rate of 79.5%,while the SAA/hs-CRP value is not obvious.The identification of the diagnosis suggests a targeted and individuation joint detection.The best advice in the infants and children group is WBC+SAA+hs-CRP,and the best advice for adult group is WBC+hs-CRP;For the infants,WBC+SAA+hs-CRP:logitP = 3.580-0.238×WBC-0.001×SAA-0.052×hs-CRP;For the children,WBC+SAA+hs-CRP:logitP=3.446-0.299×WBC-0.001×SAA-0.039×hs-CRP;For the adult,WBC+hs-CRP:logitP = 0.096-0.003×WBC-0.031 × hs-CRP.For the elderly group,it is suggested to use the WBC+BNP+PCT or comprehensive analysis;BNP and PA can reflect the severity of respiratory tract infection in elderly patients,and it has important value in judging the prognosis.ConclusionThere was no gender difference in clinical inflammatory indexes in bacteria and virus groups.SAA and hs-CRP have a certain trend of increasing with age,and there is no significant difference in WBC in different age groups.In the diagnosis of respiratory tract bacterial infection,WBC,hs-CRP,SAA,PCT,ESR,BNP,PA all have good clinical value,while in the judgment of virus infection,it is recommended to use SAA,SAA/hs-CRP.SAA has good clinical value in early warning and differential diagnosis of early infection.It is suggested that different cutoff values should be used in different age stages when detecting some inflammatory indexes.And the reasonable selection and combined detection of inflammatory markers has a greater clinical value in the diagnosis and differential diagnosis of respiratory tract infectious diseases.Some inflammatory markers such as PA and BNP can predict the severity of bacterial infection,and can be used as an effective indicator of prognosis.