Clinical Application Of PCT And BET In Stroke-related Pneumonia Complicated With Sepsis

Objective Stroke-associated pneumonia is common among patients with stroke,because of the special nature of stroke patients, the patients are prone to sepsis, and early performance is often not typical, easy to develop, leading to the death.(PCT) and endotoxin(BET) were considered to have important significance in the diagnosis of sepsis, which had important reference value in the early stage of sepsis, but there were insufficient in both of them. In this experiment, we detected the serum level of PCTand BET in patients with stroke associated pneumonia in EICU, and to explore the diagnostic value of combined detection of the two of them in the early diagnosis of stroke associated pneumonia with sepsis. Using simple examination index, to fight for the stroke associated pneumonia complicated with sepsis patients to achieve early detection, early treatment,early for clinical application of antibiotics to provide reference, and to make early evaluation of its prognosisMethods 1. Case selection: selected 2014 December to 2015 December occupancy Municipal Hospital of Eastern Hospital Emergency EICU of 70 cases of stroke associated pneumonia patients, including 42 cases of male, female 28 cases, according to the ACCP/SCCM meeting diagnostic criteria. The 70 patients divided into four groups: stroke associated pneumonia was not associated with sepsis group, stroke associated pneumonia patients with sepsis and septic bacteria culture negative group,stroke associated pneumonia patients with sepsis and septic bacteria cultured gram negtive bacteria group and stroke associated pneumonia patients with sepsis and septic bacteria culture for gram positive bacteria group. Of the 24 patients with stroke associated pneumonia who was not associated with sepsis, 14 were male and 10 were female, the average age was 71.6 years;Of the23 patients with stroke associated pneumonia patients with sepsis and septic bacteria culture negative group, 6were female, 17 male, the average age was79.7 years,;Of zhe 16 patients with stroke associated pneumonia patients with sepsis and septic bacteria cultured gram positive bacteria group male, 3were female, 13 were male, the average age was 78.7 years, Of the7 patients withstroke associated pneumonia patients with sepsis and septic bacteria culture for gram positive bacteria group,2were female, 5 male, the average age was80.3 years, All patients were performed according to their clinical manifestations and laboratory tests. Imaging examination and diagnosis of pathogen detection.2, specimen collection: all patients underwent conventional temperature, heart rate,respiratory, oxygenation index, chest imaging examination, and the blood culture, sputum culture, and blood samples were collected at first, 3, 7, 14 days, respectively.3, using quantitative immuno chromatography determination of PCT, using limulus reagent endpoint colorimetric method for determination of the bet, apparatus, reagents,and were by the German company Brahms. Compare PCT, bet in stroke associated pneumonia was not associated with sepsis sepsis and patients with sepsis and sepsis group differences, in bacteriological culture G + bacteria group and group of gram negative bacteria and bacterial culture(-) between group differences.Result1 PCT in the stroke associated pneumonia and the group of patients with no complications(0.442±0.082 VS 5.424±3.975) P<0.01The difference of BET in the patients with stroke associated pneumonia(0.2905±0.2763 VS 0.0306±0.0215) p>0.052 The difference PCT between G- in the patients with stroke associated pneumonia and G+in the patients with stroke associated pneumonia(10.53±13.85 VS 4.764±3.725)P<0.05The difference BET between G- in the patients with stroke associated pneumonia and G+in the patients with stroke associated pneumonia(0.0336 ± 0.0192VS0.0261 ±0.0106) p>0.05Difference of PCT in the patients with stroke associated pneumonia with sepsis between G-group and bacterial culture(-)group(10.53±13.85VS3.372±2.848)P<0.05Difference of PCT in the patients with stroke associated pneumonia with sepsis between G-group and bacterial culture(-)group(0.0336±0.0192VS0.0510±0.0346)p>0.053, PCT/BET in stroke associated pneumonia patients with sepsis and sepsis(98.5%)with no associated sepsis(65%) proportion increased significantly; PCT/BET in stroke associated pneumonia patients with sepsis and septic bacteria culture G- bacteria,bacterial culture(-) higher proportion than the bacterial culture high G +; bacterial culture and gram positive bacteria group 74.38% PCT/BET increased.4 to observe the relationship between mortality and PCT/BET in patients with stroke associated pneumonia and sepsis, and the higher mortality of PCT/BETConclusion in the observation of stroke associated pneumonia patients PCT appear increased(99.9%),BET in the patients with stroke associated pneumonia who was not associated with sepsis increased were not obvious. In patients with sepsis PCT, BET can be continued to rise, in poor treatment effect of the patient, bet increased more obvious. In patients with elevated PCT/BET, more prone to sepsis, and the emergence of a sustained increase in the treatment of patients with poor efficacy, poor prognosis, high mortality. In bacterial culture(-) and bacterial culture of gram positive bacteria PCT/BET were significantly increased, in the bacterial culture of G+ bacteria group also has an elevated 74.38%, and the combination of G- antibiotic treatment effect is good. In the early application of PCT/BET increased, the early application of Gbacteria antibiotics, the treatment effect is good, can improve the survival rate.