Vaule of biomarks in early diagnosis of stroke associated pneumonia

XU Dong-wei; SHEN Kan; QIU Ze-liang

doi:10.3969/j.issn.1002-1949.2015.06.006

Abstract：Objective To investigate the effect of biomarkers for early diagnosis of stroke associated pneumonia( SAP) .To provide a certain basis for clinical rational use of antibiotics.Methods Fifty two cases who consistent with the diagnosis of stroke associated pneumonia from Aug 2013 to Jul 2014 were included into SAP group.Patients in SAP group were collected the blood samples for detection serum procalcitonin ( PCT ) , C -reactive protein ( CRP ) , N -terminal pro brain natriureticpeptide ( NT-proBNP ) , D -dimer, white blood cell count ( WBC ) , percentage of neutrophils ( N ) and platelet count ( PLT) within 6 hours when appear any clinical infection symptoms.Their sputum was cultured before the use of antibiotics.ICU patients without stroke and infection at the same period were served as control group.The patients in control group were also detected the above mentioned indexes. The serum indexes in the two groups were compared by statistical analysis.Results PCT and CRP are independent predictive factors of SAP. The area under the PCT curve ( AUC ) , the sensitivity, specificity, positive predictive value and negative predictive values are 0.87, 90.39%, 78.95%, 84.46% and 85.71%, respectively.The cut off value is 0.41 ng/mL, higher than CRP ( 0.82, 82.69%, 73.68%, 81.13%, 75.68%, cutoff value: 30.68 mg/L).The PCT index in G-sub-group and mixed bacteria group is higher than G+sub-group (P<0.01, P<0.05).The PCT index between G+sub-group and mixed bacteria group has no statistical significance (P>0.05).There is no statistical significance of CRP index among all the three groups (P>0.05).Conclusion PCT is an independent predictor in early diagnosis of SAP.PCT has better ability than CRP in early diagnosis of SAP.It is more likely to be a G-bacteria infection when PCT is obviously increased in patients with SAP.