Clinical Value Of Serum Procalcitonin Detection In Traumatic Endophthalmitis

ObjectiveTo compare the differences of serum procalcitonin(PCT),white blood cell(WBC)count and neutrophil(NE)count between the observation group and the control group,and study if there are any correlations between each two indicators.To explore the diagnostic value of their separate and combined detection of traumatic endophthalmitis and explore the relevant factors of prognosis.Methods1.Materials and groupingA retrospective case-control study,51 eyes of 51 cases with traumatic endophthalmitis newly diagnosed in the First Affiliated Hospital of Zhengzhou University from Jan.2018 to Nov.2019 were collected as the observation group,and matched 51 eyes of 51 cases with cataract during the same period as the control group.The serum PCT value(ng/mL),WBC count(109/L),NE count(109/L),number of days before trauma to hospital admission,gender,age,whether vitrectomy or eye content enucleation was performed(adverse outcomes)within 20 days since admission were recorded.The differences and correlations of PCT,WBC,and NE were compared between the two groups.Receiver operating characteristic(ROC)curve was drawn to evaluate the value of PCT in diagnosing traumatic endophthalmitis.Logistic regression was used to explore the relationship between prognosis and PCT or other factors.2.Detecting methodsAll patients underwent quantitative PCT and blood routine examination within 24 hours since admission.PCT was measured by electrochemical luminescence method.The instrument and kit were full-automatic electrochemical luminescence immunoassay system and Elecsys BRAHMS PCT provided by Roche,Germany;WBC and NE counts were determined by the American BeckmanLH750 automatic five-class blood analysis assembly line.3.Statistical analysisStatistical analysis was performed using SPSS 21.0 statistical software package.The WBC,NE values and their difference values of both of the case group and the control group were in accordance with the normal distribution.The PCT difference value d followed the normal distribution after Ln(d+0.007)transformation.Paired t-test was used to compare the differences of PCT,WBC and NE between the two groups;Correlation analysis using Spearman rank correlation or Pearson correlation;Use ROC curves to analyse the results of PCT,WBC,and NE,whose cutoffs,sensitivity,specificity,and Area under the curves(AUC)were compared,and cutoffs were used as a positive value to compare the difference between the observation group and the control group by chi-square test;the influencing factors of the outcome were analyzed by Logistic regression.Non-normal statistics are expressed as median(interquartile range),normal statistics are expressed as mean ± standard deviation(Mean ± SD),and the results are all statistically significant with P<0.05.Results1.Difference and correlation analysis of PCT and other indicators between case group and control groupBy paired t test,the differences between the PCT.WBC,and NE indicators of the observation group and the control group were statistically significan(P<0.05).Correlation analysis of 102 patients showed that the three indicators had a good correlation.with each other(P=0.000).,PCT,was relative to,WBC and NE with r values of 0.382 and 0.439,repectively;and the r value of WBC and NE was 0.878.2.ROC curve analysis of PCT and other indicatorsThe AUC values from high to low are:the three indicators combined(0.966),PCT(0.879),NE(0.873),and WBC(0.783).And according to the,ROC curve,the cutoff value was taken when the Jordan index was at its maximum,and the optimal threshold for PCT diagnosis of bloodstream infection was 0.0305 ng/mL,NE was 4.76×109/L,and WBC was 8.65 × 109/L.The corresponding sensitivity of the PCT is 82.4%,the specificity is 92.2%,the NE is 74.5%,94.1%,the WBC is 60.7%;,90.2%,and the corresponding sensitivity of the three combined detection of the Jordan index is 96.1%.The specificity is 90.2%.3.Influencing factor analysisAccording to Logistic regression analysis,age had an effect on whether adverse outcomes occurred within 20 days of admission.-Patients with traumatic endophthalmitis older than 50 years were 5.5 times more likely to have adverse outcomes than patients younger than 25 years(OR=5.5).There was no effect on gender,days before admission,and PCT value at admission(P>0.05).Conclusion(1)PCT values of patients with traumatic endophthalmitis may slightly elevate,and when it reach 0.0305 ng/mL,systemic antibiotics should be considered.(2)PCT has good clinical diagnostic value for traumatic endophthalmitis,and it can be recommended as a reference index for diagnosis and treatment of endophthalmitis.