Dynamic Changes of PCT,hs-CRP,and IL-4 and Their Relationship with Short-Term Prognosis in Patients with Bacterial Liver Abscess

HU Yanwu; HU Xiaofang; YAN Bin; LIANG Rongxin; WU Bin; WANG Feng

doi:10.3639/j.issn.2095-3097.2025.11.007

Abstract：Objective To investigate the changes in procalcitonin(PCT),high-sensitivity C-reactive protein(hs-CRP),and interleukin 4(IL-4)levels in patients with bacterial liver abscess(BLA)and their relationship with short-term prognosis.Methods A total of 80 patients with BLA admitted to the Affiliated People's Hospital of Hubei University of Medicine from January 2022 to June 2024 were prospectively selected.According to the short-term prognosis,they were divided into the good prognosis group(43 cases)and the poor prognosis group(37 cases).Serum PCT,hs-CRP,and IL-4 levels were measured on days 1,3,5,and 7 after admission.Dynamic changes in serum PCT,hs-CRP,and IL-4 and clinical features were compared between patients with different prognoses.Logistic regression was used to analyze the relationship between the three factors and the short-term prognosis of BLA patients.The receiver operating characteristic(ROC)curve was drawn to analyze the value of serum PCT,hs-CRP,and IL-4 levels on day 1 after admission in evaluating the short-term prognosis of BLA patients.Results The levels of PCT,hs-CRP,and IL-4 in both groups on days 3,5,and 7 were significantly lower than those on day 1,and the magnitude of decrease in the poor prognosis group was significantly smaller than that in the good prognosis group at each time point(P<0.05).The proportions of patients with multiple bacterial infections,previous history of diabetes,multiple abscesses,liver abscess diameter>5cm,and the Acute Physiology and Chronic Health Evaluation(APACHE)Ⅱscore in the poor prognosis group were significantly higher than those in the good prognosis group(P<0.05).Logistic stepwise regression analysis showed that serum PCT,hs-CRP,and IL-4 levels on day 1 after admission and the APACHE Ⅱ score at admission were influencing factors for the short-term prognosis of BLA patients(P<0.05).ROC curve analysis showed that the area under the curve for the combined evaluation of serum PCT,hs-CRP,and IL-4 on day 1 after admission for the short-term prognosis of BLA patients was 0.815,which was significantly higher than that of any single indicator(P<0.05).The sensitivity and specificity of the combined evaluation of the three indicators were 83.78%and 62.79%,respectively.Conclusion BLA patients with good short-term prognosis showed a more significant dynamic decrease in PCT,hs-CRP,and IL-4 levels.PCT,hs-CRP,and IL-4 are closely related to the short-term prognosis of BLA patients.The combined detection of serum PCT,hs-CRP,and IL-4 levels on day 1 after admission has high clinical value for assessing the short-term prognosis of BLA patients.