Clinical study of cystatin C in assessing the severity of community acquired pneumonia / 中国基层医药

ABSTRACT

Objective To explore the clinical value of cystatin C in predicting the severity of community-acquired pneumonia(CAP).Methods From January 2016 to August 2016,the clinical data of 122 patients with CAP in Shengjing Hospital of China Medical University were retrospectively analyzed.The patients were divided into low-risk group(74 cases) and middle-high risk group (48 cases) according to pneumonia severity index (PSI).The cystatin C,procalcitonin,C-reactive protein (CRP),white blood cell (WBC) count,neutrophil percentage (NE％),D-dimer and fibrinogen(FIB) levels in hospitalized patients were detected.The relationship between cystatin C and the above related indicators and the PSI was evaluated.Draw ROC curve with cystatin C and above indicators to predict severity of CAP.Results In the low-risk group,the levels of procalcitonin,CRP,WBC count,NE％,D-dimer,FIB were[0.08 (0.04,0.23)] ng/L,[42.35(12.52,93.70)] mg/L,[7.85 (6.23,10.38)] x 109/L,(66.87 ±13.49) ％,[215.00 (134.25,410.25)] μg/L,[4.52 (3.71,5.14)] g/L,respectively,which in the middle and high risk group were [0.25 (0.07,0.54)] ng/L,[74.30 (40.45,122.75)] mg/L,[7.90 (5.78,10.63)] × 109/L,(73.97 ± 10.77) ％,[417.50 (239.75,730.00)] μg/L,[4.57 (3.87,5.08)] g/L,respectively,the differences of NE％,procalcitonin,CRP,D-dimer between the two groups were statistically significant (t =3.064,U =3.024,2.800,3.771,all P ＜0.05),the WBC count,FIB had no statistically significant differences between the two groups (all P ＞ 0.05).In the low-risk group,the level of cystatin C was [0.82 (0.68,0.91)] mmol/L,which in the middle -high risk group was [1.32 (1.12,1.54)] mmol/L,the difference between the two groups was statistically significant (U =7.978,P ＜ 0.001).When the level of cystatin C was 0.975 mmol/L,the sensitivity for the diagnosis of pneumonia severity was 95.8％,with a specificity of 85.1％.Conclusion Monitoring cystatin C levels can be used as an indicator of inflammatory response and can predict the severity of pneumonia.