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《Journal of Molecular Diagnostics and Therapy》 2018-05
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Changes of serum hs-CRP level in elderly patients with severe pneumonia and its clinical significance

SUN Chunrong;HUANG Linna;CUI Xiaoyang;YANG Ji;Department of Respiration,Beijing Chui Yang Liu Hospital Affiliated to Tsinghua University;The Respiratory Center of China-Japan Friendship Hospital;The National Respiratory Disease Clinical Research Center of Respiratory and Critical Care Medicine of China-Japan Friendship Hospital;  
Objective To study the clinical value of serum hs-CRP in elderly patients with the severe respiratory disease. Methods The clinical data of 83 elderly patients with severe pneumonia diagnosed in the Respiratory Center of China-Japan Friendship Hospital from June 2016 to September 2017 were retrospectively analyzed.According to the outcome of the patients,57 of them had better prognosis were classified into Group A,while 26 patients had poor prognosis with treatment failure were classified into Group B. Age,gender,BMI,basic diseases,and acute physiology and chronic health scoring systemⅡ(APACHEⅡ)score of 2 groups of patients were recorded,and on the 1 st,4 th,and 7 th day,blood was taken from the vein of the patients,and serum was collected.The levels of hs-CRP and PCT were detected by ELISA.Multivariate Logistic regression analysis was performed to study the influencing factors of elderly patients with severe respiratory disease. Results The scores of serum PCT,hs-CRP and APACHEⅡ in group B were(5.73±1.13)ng/m L,(6.84±0.45)ng/m L and(34.62±5.27)respectively after 7 days of treatment,which were significantly higher than those in the group A(P0.05). After treatment,the scores of PCT,hs-CRP and APACHEⅡin the group A decreased,but increased in the group B(P0.05). Multivariate Logistic regression analysis showed that PCT,hs-CRP and APACHE II score were independent risk factors for the poor prognosis for elderly patients. The ROC curve analysis showed that the AUC of hs-CRP in predicting the prognosis of patients was 0.834(0.518-0.916).The 3 indexes of PCT,hs-CRP and APACHE Ⅱ score can be used to predict the effectiveness of the test. The AUC is 0.864(0.691-0.946),and the sensitivity and specificity are85.8% and 86.4%,respectively.Conclusion The increase of serum hs-CRP level after the 7 th day of treatment suggests that the prognosis may be poor. It is necessary to take timely targeted clinical treatment to reduce the inflammatory response in vivo to improve the prognosis of patients.
【CateGory Index】: R563.1
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