Anti-infection value of combined determination of serum levels of procalcitonin, C-reactive protein,prealbumin, white blook cell in the elderly with bacterial infection / 中华老年医学杂志

ABSTRACT

Objective To evaluate the clinical significance of the combined determination of serum procalcitonin (PCT),C reactive protein(CRP),prealbumin(PA)and white blood cell(WBC) in curative effect and prognosis of elderly patients with bacterial infection.Methods Serum PCT,CRP,PA and WBC levels and their dynamic changes of 70 patients with bacterial infection from intensive care unit(ICU)were measured.The patients with bacterial infection were classified into serious infection group and local infection group.And the comparison with virus infection group was made.Results The levels of PCT(18.00±3.20)μg/L and CRP(86.17±10.64)mg/L in serious infection group and local infection group[PCT(2.03±0.46)μg/L,CRP(50.24±7.45)mg/L] were increased.The contents of PA were reduced[(3.214±0.88)mg/L,(12.89± 1.03)mg/L].The levels of WBC were increased mildly[(8.89±1.23) × 109/L,(6.54±0.87) × 109/L].The differences were statistically significant between bacterial infection groups(serious infection group and local infection group) and virus infection group [PCT (0.21 ±0.06)μg/L,CRP (5.21 ±0.84) mg/L,PA (20.14 ±2.57)mg/L,WBC (5.30 ± 0.93) × 109/L] (P＜ 0.01).Serum PCT,CRP.PA and WBC showed significant differences between serious infection group and local infection group(P＜0.01).After antibiotic treatment,the levels of PCT (0.5 ± 0.08) μg/L,CRP (10.32 ± 1.65) mg/L and WBC (6.30± 0.91) × 109/L in bacterial infection group were reduced obviously and the concentration of PA (18.19±2.66)mg/L was elevated compared with before treatment [PCT(11.61±8.27)μg/L,CRP (71.80±20.09)mg/L,WBC(7.95± 1.59) × 109/L,PA(7.08±4.87)mg/L] (P＜0.01).Correlative analysis was performed between PCT and others indicators before and after antibiotic treatment in bacterial infection group and virus infection group.There was positive correlation between PCT and CRP,WBC before(r=0.586,0.445) and after treatment (r=0.688,0.463) in bacterial infection group.PCT and WBC(r=0.432) were positively correlated after treatment,while no correlation existed between PCT and others indexes in virus infection group(r＜0.306).When comparing sensitivity and specificity of PCT and CRP for diagnosis of bacterial infection disease,the sensitivity (95.7％) of PCT was similar to that of CRP.The specificity of PCT(86.7％) was remarkably higher than that of CRP(73.3％).Conclusions The combination of serum PCT,CRP.PA and WBC is valuable for early diagnosis of bacterial infection disease.Monitoring PCT level dynamically would assist an evaluation of curative effect and disease outcome of elderly patients.