The Observational Study Of Serum Procalcitonin And C-reactive Protein In The Acute Exacerbation Of Athma

Objective:Observe the changes of serum procalcitonin?PCT?and C-reactive protein?CRP?in the acute exacerbation of asthma.This article mainly compares the difference between PCT and CRP in patients with simple asthma and asthma with infection.Simultaneously,the sensitivity and specificity of PCT and CRP are measured to explore the clinical value of PCT and CRP in the acute exacerbation of asthma.Methods:A total of 275 patients with acute exacerbation of asthma admitted to the Department of Respiratory Medicine,the Second Affiliated Hospital of Dalian Medical University from January 2015 to December 2017 were included in the study.The general data of the patients were recorded including age,sex,and duration of disease,as well as white blood cell count?WBC?,neutrophil percentage?N%?,eosinophil percentage?EOS%?,PCT,CRP,pulmonary function test?FEV₁/FVC%?,arterial blood gas analysis?pH,PaO₂,PaCO₂?,body temperature?T?,respiratory?RR?,heart rate?HR?and other clinical data.Thoracic CT and/or blood cultures were performed in all patients when they were admitted to the hospital.Patients with asthma who were diagnosed with inflammatory exudative changes on chest CT and/or positive blood cultures were divided into asthma group and asthma with infection group,between the two groups as above data for comparison;In addition,PCT was divided into PCT normal group?PCT?0.06ng/mL?and PCT elevated group?PCT>0.06ng/mL?with cut-off line of 0.06ng/mL,the above data were compared again between the two groups;the sensitivity and specificity of PCT and CRP were tested,and the diagnostic value of PCT and CRP in asthma with infection was analyzed by ROC curve to explore the clinical significance of PCT and CRP in acute exacerbation of bronchial asthma.SPSS21.0 software was used for statistical analysis to processing each data.The measurement data were first tested for normal distribution.Measured data with normal distribution were expressed as mean±standard deviation??X±S?.The t-test was used.Data with non-normal distribution were expressed as median?25th percentile to 75th percentile?,using the Mann-Whitney U test,and the chi-squared test was used for the count data.Using different measured values as critical values,the sensitivity and specificity were calculated based on gold standard test results.The ROC curves of the subjects were plotted,and the area under the curve was compared to obtain the diagnostic value.P<0.05 was statistically significant.Results:Compared with simple asthma group,PCT was significantly higher in asthma with infection group?0.04?0.04-0.05?vs 0.05?0.04-0.09?,P<0.05?.CRP in asthma with infection group was higher than that in simple asthma group?1.81?0.42-5.32?vs5.81?0.63-17.58?,P<0.05?,FEV₁/FVC in asthma with infection group was lower than in simple asthma group?74.16±9.94 vs 68.57±11.24,P<0.05?.There was no significant difference in blood WBC,N?%?,EOS?%?,pH,PaO2,PaCO2,T,HR,RR between the two groups?all P>0.05?.The specificity of PCT was88.4%,the sensitivity was 44.12%,the area under the ROC curve was 0.655?95%CI0.573-0.737?,the optimal cut-off line was 0.065 ng/ml,the specificity of CRP was73.91%,and the sensitivity was 55.88%.The area under the ROC curve was 0.641?95%CI 0.561-0.721?and the best cut-off line was 5.35 mg/L.Compared with CRP,the specificity of PCT was significantly higher?p<0.05?and the diagnostic value was higher;A total of 54 patients in the PCT elevated group accounted for 19.64%of the patients,of which PCT significantly increased?P>0.25ng/mL?in 7 patients,accounting for 2.4%.CRP in the elevated PCT group was significantly higher than that in the PCT normal group.?1.92?0.44-6.45?vs 4.06?0.78-14.73?,P=0.013?.There was no significant difference in WBC,N?%?,EOS?%?,pH,PaO2,PaCO2,T,HR,RR between the two groups?all P>0.05?.Conclusion:Serum procalcitonin and C-reactive protein have certain clinical significance for the assessment of infections in the acute exacerbation of asthma.Serum procalcitonin has higher diagnostic value than C-reactive protein and can be used as a simple biological indicator to guide antibacterial drug treatment.