Correlation between serum PCT and CRP levels and clinical outcome in patients with acute brucellosis / 中华地方病学杂志

ABSTRACT

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.