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Objective:To investigate the correlation between serum PCT and CRP levels and clinical outcome in patients with acute brucellosis.Methods:From June 2014 to June 2020, 73 patients with acute brucellosis diagnosed in Anji County People's Hospital, Huzhou City were selected as acute brucellosis group and 68 patients with chronic brucellosis as chronic brucellosis group; another 60 healthy people were selected as control group. The levels of serum PCT and CRP of each group were measured by chemiluminescence assay and immunoturbidimetric assay. Patients with acute brucellosis were treated with rifampicin, doxycycline and rifapentine capsules for 9 weeks. The levels of serum PCT and CRP in three groups and patients with acute brucellosis with different therapeutic effects were compared. Univariate and multivariate Cox regression analysis were used to analyze the related factors affecting the efficacy of patients with acute brucellosis. The area under curve (AUC) and cut-off value of receiver operating characteristic (ROC) curve of PCT and CRP were used to evaluate the diagnosis of acute brucellosis.Results:The levels of serum PCT and CRP in acute brucellosis group [(3.25±0.49) ng/ml, (31.28±6.56) mg/L] were higher than those in chronic brucellosis group [(0.12±0.05) ng/ml, (5.21±0.89) mg/L] and control group [(0.03±0.01) ng/ml, (2.63±0.37) mg/L], and those in chronic brucellosis group were higher than those in control group ( P < 0.05). In acute brucellosis patients, 56 cases were effective and 17 cases were ineffective. The levels of serum PCT and CRP in ineffective patients were higher than those in effective patients ( P < 0.05). Univariate Cox regression analysis showed that there were significant differences in leukocyte count, neutrophil count, PCT and CRP levels among acute brucellosis patients with different therapeutic effects ( P < 0.05). Multivariate Cox regression analysis showed that leukocyte count, neutrophil count, PCT and CRP levels were the risk factors for therapeutic effect ( P < 0.05). The diagnostic evaluation showed that the sensitivity and specificity of PCT in the diagnosis of acute brucellosis were 95.24% and 80.00%, respectively; and the sensitivity and specificity of CRP in the diagnosis of acute brucellosis were 93.10% and 80.00%, respectively. Conclusion:The levels of serum PCT and CRP in patients with acute brucellosis are significantly increased, and they are risk factors for therapeutic effect, which should be used as reference indexes for diagnosis and treatment of acute brucellosis.
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OBJECTIVE: To explore the characteristics of traditional Chinese medical syndrome (TCM syndrome) of hepatocirrhosis. METHODS: Clinical information from the four diagnosis methods of traditional Chinese medicine (TCM) and related laboratorial indexes were systematically collected from 223 hepatocirrhosis cases, and the multi-statistical methods including systematic cluster analysis, principal component analysis, stepwise discrimination and variance analysis were made with the software SAS 6.11. RESULTS: Multi-analysis showed that there were 3 categories of syndrome characteristics. Type 1 (134 cases): damp heat, blood stasis, deficiency of liver and spleen Qi; Type 2 (62 cases): deficiency of both Qi and Yin with severe deficiency of Qi, heat with severe dampness, blood stasis; Type 3 (27 cases): deficiency of both Qi and Yin with severe deficiency of Yin, stasis and heat or dampness. Analysis of the changes of the related laboratorial indexes among the three types of syndrome showed that Type 1 mainly manifested asthenia syndrome with sthenia syndrome, and its indexes of AST, ALT, GGT levels were markedly higher than those of Type 2 and Type 3, both of which mainly showed sthenia syndrome with asthenia syndrome, and that Type 3 was in active inflammation, deficiency of both Qi and Yin (deficiency of Yin > deficiency of Qi), and its FN, Alb, FV, FVII, PLT, PCT levels were obviously reduced. CONCLUSION: The multi-statistical methods can reveal the characteristics and regularity of TCM syndrome of hepatocirrhosis, and the 3 categories of syndrome characteristics basically conform to clinical manifestations. The result of TCM syndrome distribution and laboratorial indexes infer that damp heat is the pathological basis of hepatocirrhosis, and the degree of liver function disorder and liver damage may be the pathological basis of deficiency of Yin of both liver and kidney.