Procalcitionin as a diagnostic marker to distinguish upper and lower gastrointestinal perforation.

AIM: To assess the accuracy of serum procalcitionin (PCT) as a diagnostic marker in verifying upper and lower gastrointestinal perforation (GIP). METHODS: This retrospective study included 46 patients from the surgical intensive care unit (ICU) of the Second Affiliated Hospital of Harbin Medical University who were confirmed to have GIP between June 2013 and December 2016. Demographic and clinical patient data were recorded on admission to ICU. Patients were divided into upper (n = 19) and lower (n = 27) GIP groups according to the perforation site (above or below Treitz ligament). PCT and WBC count was obtained before laparotomy and then compared between groups. Meanwhile, the diagnostic accuracy of PCT was analyzed. RESULTS: Patients with lower GIP exhibited significantly higher APACHE II score, SOFA score and serum PCT level than patients with upper GIP (P = 0.017, 0.004, and 0.001, respectively). There was a significant positive correlation between serum PCT level and APACHE II score or SOFA score (r = 0.715 and r = 0.611, respectively), while there was a significant negative correlation between serum PCT level and prognosis (r = -0.414). WBC count was not significantly different between the two groups, and WBC count showed no significant correlation with serum PCT level, APACHE II score, SOFA score or prognosis. The area under the receiver operating characteristic curve of PCT level to distinguish upper or lower GIP was 0.778. Patients with a serum PCT level above 17.94 ng/dL had a high likelihood of lower GIP, with a sensitivity of 100% and a specificity of 42.1%. CONCLUSION: Serum PCT level is a reliable and accurate diagnostic marker in identifying upper or lower GIP before laparotomy.

Diagnosis value of age-specific Procalcitionin and C-reactive protein on early-onset neonatal sepsis / 实用医学杂志

Objective To compare different diagnosis values of age-specific procalcitionin (PCT) and C-reactive protein (CRP) on early-onset neonatal sepsis (EONS) during the first 72h of life.Methods From September 2008 to December 2015,96 neonates (including 2 confirmed sepsis and 94 clinical sepsis) without severe complications were chosen as the EONS group and 170 non-infectious newborns as the control group.A total of 605 blood samples were collected from all 266 newborns.Serum concentration of PCT and CRP were measured in both the EONS group and the control group at each age over the first 72 h of life.The diagnostic value of PCT and CRP within 1 ～ 12 h and 13 ～ 24 h and 25 ～ 48 h and 49 ～ 72 h of life was evaluated by calculating the cut-off values,sensitivity,specificity,and the area under the receiver operating characteristic curve (ROC).Results PCT and CRP levels of neonates within each age in the EONS group were significantly higher than those in the control group during the first 72h of life.(all P ＜ 0.05).Within 1 ～ 12 h,13 ～ 24 h,25 ～ 48 h and 49 ～ 72 h of life,the cutoff value of PCT was 0.45 μg/L (sensitivity 84.2％,specificity 74.4％),1.885 μg/L (sensitivity 73.5％,specificity 75％),0.995 μg/L (sensitivity 82.4％,specificity 74.1％) and 0.51 μg/L (sensitivity 83.3％,specificity 79.2％) respectively;that of CRP3 185 mg/L (sensitivity 68.4％,specificity 82.1％),6.29 mg/L (sensitivity 58.8％,specificity 89.7％),8.615 mg/L (sensitivity 54.3％,specificity 93.9％) and 10.27 mg/L (sensitivity 59.1％,specificity 100％) respectively,and the area under ROC of PCT for the diagnosis of EONS was 0.767,0.754 and 0.755,and 0.8 respectively;that of CRP 0.773,0.8,0.815 and 0.789 respectively.Conclusions There are age-specific cut-off values of PCT and CRP in the diagnosis of EONS without severe complications during the first 72 h of life.Both PCT and CRP are moderately accurate for the diagnosis of EONS.PCT may be more helpful for the early diagnosis of EONS for its higher sensitivity but CRP presents higher specificity.

Diagnostic value of procalcitionin in infectious diseases / 国际检验医学杂志

Objective To evaluate the diagnostic value of procalcitionin (PCT ) in infectious diseases .Methods Levels of PCT , C reaction protein (CRP) and white blood cells (WBC) were detected and compared among 103 cases of bacterial infection ,77 ca‐ses of viral infections and 60 cases of non‐infected patients .Results PCT level of most bacterial infection patients was higher than 0 .5 ng/mL ,and that of viral infection patients was less or equal to 0 .5 ng/mL .Proportion of bacterial infection patients with differ‐ent PCT level was different with that of viral infection patients (P<0 .05) .PCT ,CRP and WBC levels in bacterial infection patients were higher than viral infection patients and non‐infected patients (P<0 .05) .Positive rates of PCT ,CRP and WBC in bacterial in‐fection patients were higher than viral infection patients and non‐infected patients (P<0 .05) .Conclusion PCT might be with high diagnostic sensitivity and specificity to infectious diseases ,with important diagnostic value .

The application of serum procalcitonin determination in the diagnosis of emergency patients with fever / 国际检验医学杂志

Objective To evaluate the serum rocalcitonin(PCT) determination in the diagnosis of emergency patients with fever . Methods 120emergencypatientswithfeverwereenrolledinthestudy,whoseserumsamplesweretestedbyusingelectrochemilu‐minescence immunoassay for PCT concentrations ,at the same time white blood cells(WBC) count and C reactive protein(CRP) were also determined .Bacterial culture results were used as gold standard for the diagnosis of bacterial infection .WBC>10 .0 × 109/L,CRP>10mg/L,PCT>0.5μg/Lwerethejudgmentcriteriafortheevaluationofthoseindicators.Results 73casesofpatients′bacteria culture results were positive ,47 patients′bacteria culture results were negative;63 cases of patients were with PCT ,WBC and CRP levels elevated at the same time;2 patients′WBC count elevated ,while PCT and CRP concentrations did not ;6 patients′serum PCT concentrations increased ,while WBC and CRP levels didn′t ;4 patients′serum PCT and CRP concentration increased , while WBC count didn′t ;35 patients′PCT ,WBC and CRP kept at low levels .Conclusion Serum PCT concentration could be used as an auxiliary diagnosis indicator in the diagnosis of emergency patients with fever .

Clinical application of combined detection of three indicators in pulmonary tuberculosis patients accompanied with infection / 国际检验医学杂志

Objective To explore the clinical significance of the three indicators combined detection that plasma endotoxin,pro-calcitonin (PCT)and (1,3)-β-D-glucan(BG)in pulmonary tuberculosis patients complicated with bacterial,fungal infection.Methods Retrospective investigation was conducted in 240 pulmonary tuberculosis patients,who were divided into gram negative bacteria (G- )group(39cases),gram positive bacteria (G+ )group(45 cases)including fungal,germ-free group(156 cases).Other 45 healthy people were selected into control group.The levels of plasma endotoxin,PCT and BG in the four groups were compared.Results The levels of plasma endotoxin(0.682±0.418)EU/mL,PCT(2.93±0.87)μg/L in the G- group were significant higher than those of the G+ group (0.063±0.034)EU/mL,(0.85±0.52)μg/L,the difference was significant (P <0.05).The levels of the plasma endotoxin,PCT in the G- group were higher than those of the germ-free group.The levels of plasma endotoxin,PCT and BG in the control group had no significant difference with those of the germ-free group.Conclusion The combined detection of plasma endo-toxin,PCT and BG have some clinical value on the early diagnosis of the patients with pulmonary tuberculosis complicated with G-fungal infection for the advantages of fast and sensitiveness.

The significance of serum procalcitionin in children with acute liver failure / 中国小儿急救医学

Objective To study the changes of serum procaleitonin(PCT) in the children with acute liver failure,and to investigate the relationship between PCT and severity and prognosis of acute liver failure.Methods A retrospective analysis of 24 children with acute liver failure admitted in Shengjing Hospital Affiliated to China Medical University from October 2010 to November 2013 was performed.The changes of serum PCT,blood routine,C-reactive protein,blood culture,virus,Mycoplasma pneumoniae antibody,blood ammonia,serum alaninetransaminase,serum glutamic oxaloacetic transaminase,international normalized ratio and prothrombin time level were observed.Results The serum PCT of children with acute liver failure originally increased at different degree.The serum PCT of 21 cases was more than 0.5 μg/L.The dynamic monitoring results of serum PCT in 6 cases on day 1,day 3,and day 8 were (12.55 ± 13.65) μg/L,(5.62 ±8.12) μg/L,(0.15 ± 0.26)μg/L,respectively,which showed decrease tendency.In 24 children with acute liver failure,serum PCT,international normalized ratio,blood ammonia of survival cases were significantly decreased compared with death cases[(28.37 ±60.22) μg/L vs(12.24 ± 14.76) μg/L;4.28 ± 2.50 vs 3.16 ±1.41 ; (213.30 ± 185.87) μmol/L vs (128.89 ± 102.17) μmol/L] (P ＜ 0.05).Conclusion Acute liver failure could increase the levels of serum PCT.Serum PCT may be an effective index to evaluate liver function,curative effect and prognosis of patients with acute liver failure.

The roles of PCT,hs-CRP and SAA in the discrimination of bacterial and viral infections / 国际检验医学杂志

Objective To explore the effects of PCT ,hs‐CRP and SAA on the discrimination of bacterial and viral infections . Methods The concentrations of PCT ,hs‐CRP and SAA in viral infection group ,bacterial infection group ,fungal infection group , mixed infection group and non‐infection group were detected respectively .The diagnostic efficiency of PCT ,hs‐CRP and SAA for the differential diagnosis of bacterial and viral infections were analyzed .Results Among viral infection group ,bacterial infection group ,fungal infection group ,mixed infection group and non‐infection group ,there were significant differences in the concentrations of PCT ,hs‐CRP and SAA (P<0 .05) .PCT worked at the maximum efficiency for the differential diagnosis of bacterial and viral infections .Conclusion The detection of serum PCT ,hs‐CRP and SAA can be used for the diagnosis of bacterial infections and the differential diagnosis with other infections .

The clinical value of serum procalcitionin in the diagnosis of neonates septicemia / 中国基层医药

Objective To assess the application value of serum procalcitonin(PCT)for the differentiation between the neonates with or without septicemia.Methods PCT,C-reactive protein(CRP),blood and blood culture tests were done in 75 cases of neonatal septicemia as the therapy group,and 74 neonates without the signs of infection as the control group after the admission of our hospital One week later,the therapy group also re-examined the PTC and CRP tests.Furthermore,the results were analyzed.Results The levels of CRP(23.26±5.68)mg/L and PCT(7.61±4.53)ng/L in therapy group were dramatically reduced compared with(4.09±1.09)mg/L,(1.95±0.25)ng/L in therapy group,and(6.42±4.54)mg/L,(0.45±0.16)ng/L in the control group before therapy,the t values are 28.71,12.97 and 19.97,14.08 respectively,and p value are both less than 0.01.The positive rates of PTC,CRP and blood culture were 82.7％,48.0％ 28.0％ before the admition to hospital.The differences of PTC and CRP,PTC and blood culture had statistical significances(x2=5.64,P＜0.05;x2=10.40,P＜0.01).If 2.5 μg/L of PCT and 8mg/L of CRP would be regarded as cutoff point in our study,the sensitivity and specificity of PCT or CRP for diagnosis of neonatal septicemia was 82.7％ and 80.3％,48.7％ and 78.4％.Conclusion Our data suggested that the serum PTC is a valuable marker for the early diagnosis of neonatal septicemia.