ABSTRACT
Objective To explore the diagnostic values of combined detection of serum procalcitonin (PCT) and β2 microglobulin (β2MG) in tsutsugamushi disease.Methods Serum PCT and β2MG were compared in cases of tsutsugamushi disease and fever patients at the same time,who were hospitalized at Fourth Affiliated Hospital of Guangxi Medical University from June 2014 to May 2017.The best diagnosis cut-off value of tsutsugamushi disease was calculated by receiver operating characteristic (ROC) curve.Results A total of 57 cases of tsutsugamushi disease,40 cases of sepsis,17 cases of acquired immunodeficiency syndrome (AIDS),17 cases of severe community-acquired pneumonia (SCAP),63 cases of common community-acquired pneumonia (CCAP),14 cases of pulmonary tuberculosis (PTB),20 cases of upper respiratory tract infection,13 cases of other infectious fever and 28 cases of non-infectious fever patients were selected.The level of serum PCT in tsutsugamushi disease [0.87 (0.68-1.34) μg/L] was higher than those in AIDS [0.47 (0.20-1.12) μg/L],CCAP [0.17 (0.09-0.51) μg/L],PTB [0.13 (0.05-0.18) μg/L],upper respiratory tract infection [0.23 (0.05-0.48) μg/L] and non-infectious fever [0.09 (0.06-0.13) μg/L],but was lower than those in sepsis [5.00 (1.04-18.78) μg/L] and SCAP [3.35 (0.76-14.41) p,g/L,P ＜ 0.05],while the difference was not significant compared with other infectious fever [0.76 (0.13-1.99) μg/L,P ＞ 0.05].The level of serum β2MG in tsutsugamushi disease [(5.67 (4.47-7.90) mg/L] was higher than those in sepsis [2.83 (2.10-4.54) mg/L],AIDS [3.85 (3.19-5.22) mg/L],SCAP [3.83 (2.98-5.58) mg/L],CCAP [1.99 (1.51-2.75) mg/L],PTB [1.92 (1.37-3.00) mg/L],upper respiratory tract infection [2.02 (1.25-2.74) mg/L],other infectious fever [2.45 (1.51-4.12) mg/L] and non-infectious fever [2.99 (2.06-4.30) mg/L,P ＜ 0.05].ROC curve showed that the most suitable diagnosis cut-off value of serum PCT in tsutsugamushi disease was 0.53 μg/L,the sensitivity was 94.7％,and the specificity was 60.4％.The critical value of serum β2MG was 3.74 mg/L in diagnosis of tsutsugamushi disease,its corresponding sensitivity and specificity were 91.2％ and 75.9％,respectively.The sensitivity and specificity of combined serum PCT and β2MG in diagnosis of tsutsugamushi disease was 87.7％ and 86.3％,respectively.Conclusion Combined detection with serum PCT and β2MG can improve early diagnosis of tsutsugamushi disease.
ABSTRACT
Objective To analyze the prevalence and clinical characteristics of brucellosis in Liuzhou that is a non-pasture area,and to provide a basis for diagnosis and treatment of brucellosis.Methods Time distribution,population distribution,main symptoms,onset time,serum procalcitonin (PCT),C reactive protein (CRP) and blood routine were analyzed in 20 patients with brucellosis at the Fourth Affiliated Hospital of Guangxi Medical University from January 2013 to December 2016,and the results were compared with those of 35 cases of sepsis.Results A total of 20 cases brucellosis was conformed,13 cases (65.0％,13/20) occurred in 2016,and the incidence was increased year by year.Sixteen cases (80.0％,16/20) had a history of exposure to cattle and sheep.The ages of patients in brucellosis group were younger than those in sepsis group [(46.6 + 10.4) years vs (59.4 + 17.0) years,t =-3.49,P ＜ 0.05],the onset time in brucellosis was longer than those in sepsis group [24.5(14.3-39.8) d vs 7.0 (6.0-12.0) d,U =90.00,P ＜ 0.05].Eight cases (100.0％,8/8) of brucellosis showed that the PCT ＜ 0.5 μg/L,while only 3 cases (8.6％,3/35) in sepsis group,the difference was significant statistically between the two groups (x2 =23.99,P ＜ 0.05).Majority of brucellosis showed that white blood cells (70.0％,14/20),neutrophils (85.0％,17/20),lymphocytes (90.0％,18/20),neutrophil ratio (80.0％,16/20) and lymphocyte ratio (55.0％,11/20) were normal.Compared with the sepsis group,the levels of PCT [0.30(0.19-0.38) μg/L vs 4.70 (1.30-18.28) μg/L,U =0.00,P ＜ 0.05],CRP [24.43 (12.78-45.06) mg/L vs 101.60 (62.63-163.58) mg/L,U =100.00,P ＜ 0.05],white blood cells [5.76 (4.76-7.99) × 109/L vs 12.34 (8.50-16.12) × 109/L,U =91.50,P ＜ 0.05] and neutrophils [3.22(2.49-4.65) × 109/L vs 10.40(7.76-14.05) × 109/L,U =58.00,P ＜ 0.05] in brucellosis were lower,while lymphocytes [1.80(1.26-2.69) × 109/L vs 0.91(0.52-1.36) × 109/L,U =121.50,P ＜ 0.05] were higher.Conclusion The number of patients with brucellosis is increased in a non-pasture area these years,and the PCT,CRP and blood routine are different from those in sepsis,so physicians should pay much more attention to the disease in early diagnosis and treatment.