Clinical value of PCT, WBC, and CRP in diagnosis of common bile duct stones with bile duct infection and systemic inflammatory response syndrome_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

JIANG Qingbin ,  LI Dongsong , HONG Wenguang , CAI Huanwu , SU Shuyan

Department of Second General Surgery, Chaozhou People’s Hospital, Chaozhou, Guangdong 521011, P. R. China;

Corresponding?author：

LI Dongsong, Email: ldsdoctor@163.com

Keywords：

bile duct stone; biliary tract infection; systemic inflammatory response syndrome; procalcitonin; C-reactive protein; WBC count

DOI：

10.7507/1007-9424.201910083

Video：

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Objective To study the clinical value of procalcitonin (PCT), WBC count, and C-reactive protein (CRP) in diagnosis of common bile duct stones with acute bile duct infection and systemic inflammatory response syndrome (SIRS).Methods A total of 80 patients with bile duct stones were retrospectively analyzed, which were divided into two groups, SIRS group (n=40) and non-SIRS group (n=40). The numerical value of PCT, WBC count, and CRP were detected on 1, 4, and 7 day after admission, and calculated the score of acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) on 1 day after admission. Then analyzed the clinical value of PCT, WBC count, and CRP in diagnosis of common bile duct stones with acute bile duct infection and SIRS.Results Each area under the ROC curve of PCT, CRP, and WBC count were 0.81, 0.78, and 0.72, respectively, with significant difference (P<0.05). The PCT, CRP, and WBC count had a certain accuracy in diagnosis of common bile duct stones with acute bile duct infection and SIRS. The positive-relationship between PCT, CRP, WBC count and APACHE Ⅱ score was significant (r=0.91, P<0.01; r=0.88, P<0.01; r=0.69, P<0.01).Conclusion To detect the numerical value of PCT, WBC count, and CRP had significant clinical value in diagnosis of common bile duct stones with acute bile duct infection and SIRS.

Citation： JIANG Qingbin, LI Dongsong, HONG Wenguang, CAI Huanwu, SU Shuyan. Clinical value of PCT, WBC, and CRP in diagnosis of common bile duct stones with bile duct infection and systemic inflammatory response syndrome. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2020, 27(8): 945-949. doi: 10.7507/1007-9424.201910083 Copy

1.	崔曉婷, 鄭紅曉, 李海燕, 等. 血清BNP與hs-CRP和PCT對慢性心力衰竭患者肺部感染的診斷評價. 中華醫院感染學雜志, 2019, 29(11): 1651-1655.
2.	Mir F, Nisar I, Tikmani SS, et al. Simplified antibiotic regimens for treatment of clinical severe infection in the outpatient setting when referral is not possible for young infants in Pakistan (Simplified Antibiotic Therapy Trial[SATT]): a randomised, open-label, equivalence trial. Lancet Glob Health, 2017, 5(2): e177-e185.
3.	劉倩, 虎亞光, 柴爾青. 急性腦出血合并肺部感染患者病原菌分布、藥敏性及血清PCT、hs-CRP水平分析. 中國病原生物學雜志, 2019, 14(8): 952-954, 979.
4.	朱夢莉, 彭麗清, 袁光新, 等. SIRS 標準與 SOFA 和 qSOFA 評分對急診疑似感染患者的預后預測價值. 中華醫院感染學雜志, 2019, 29(19): 2894-2898.
5.	Ratzinger F, Haslacher H, Perkmann T, et al. Sepsis biomarkers in neutropaenic systemic inflammatory response syndrome patients on standard care wards. Eur J Clin Invest, 2015, 45(8): 815-823.
6.	Weiss SL, Fitzgerald JC, Pappachan J, et al. Global epidemiology of pediatric severe sepsis: the sepsis prevalence, outcomes, and therapies study. Am J Respir Crit Care Med, 2015, 191(10): 1147-1157.
7.	Lee H. Procalcitonin as a biomarker of infectious diseases. Korean J Intern Med, 2013, 28(3): 285-291.
8.	伍方紅, 許得澤, 韋繼政, 等. 降鈣素原及C反應蛋白檢測在術后重度膿毒血癥患者預后判斷中的意義. 廣東醫學, 2013, 34(9): 1369-1371.
9.	Haubitz S, Mueller B, Schuetz P. Streamlining antibiotic therapy with procalcitonin protocols: consensus and controversies. Expert Rev Respir Med, 2013, 7(2): 145-157.
10.	Jain S, Sinha S, Sharma SK, et al. Procalcitonin as a prognostic marker for sepsis: a prospective observational study. BMC Res Notes, 2014, 23(7): 458-464.
11.	Mat Nor MB, Md Ralib A. Procalcitonin clearance for early prediction of survival in critically ill patients with severe sepsis. Crit Care Res Pract, 2014, 32(8): 1903-1914.
12.	何健卓, 譚展鵬, 張敏州, 等. 血必凈注射液對嚴重膿毒癥患者血流動力學及內皮功能影響的前瞻性研究. 中華危重病急救醫學, 2015, 27(2): 127-132.
13.	Kip MM, Kusters R, IJzerman MJ, et al. A PCT algorithm for discontinuation of antibiotic therapy is a cost-effective way to reduce antibiotic exposure in adult intensive care patients with sepsis. J Med Econ, 2015, 18(11): 944-953.
14.	鄭超, 喬陳財, 陳奕, 等. 菌血癥患者細菌感染程度與血清PCT、hs-CRP水平變化研究. 重慶醫科大學學報, 2017, 42(2): 240-243.
15.	李志英, 周軍. 聯合檢測血清sTREM-1、IL-17、hs-CRP在肺炎中的診斷價值. 中國老年學雜志, 2018, 38(17): 4167-4169.
16.	趙魯新, 仝冰云, 姜寧, 等. 血清IL-12與hs-CRP對新生兒感染性疾病的診斷效果研究. 中華醫院感染學雜志, 2019, 29(7): 1106-1108, 1112.
17.	Brennan MB, Osterby K, Schulz L, et al. Impact of low procalcitonin results on antibiotic administration in hospitalized patients at a tertiary care center. Infect Dis Ther, 2016, 5(2): 185-191.
18.	李麗娟, 陳煒, 古旭云, 等. 血漿PCT和CRP水平的動態變化對膿毒癥嚴重程度的評估及其相關性研究. 中國實驗診斷學, 2013, 17(6): 1010-1013.

1. 崔曉婷, 鄭紅曉, 李海燕, 等. 血清BNP與hs-CRP和PCT對慢性心力衰竭患者肺部感染的診斷評價. 中華醫院感染學雜志, 2019, 29(11): 1651-1655.
2. Mir F, Nisar I, Tikmani SS, et al. Simplified antibiotic regimens for treatment of clinical severe infection in the outpatient setting when referral is not possible for young infants in Pakistan (Simplified Antibiotic Therapy Trial[SATT]): a randomised, open-label, equivalence trial. Lancet Glob Health, 2017, 5(2): e177-e185.
3. 劉倩, 虎亞光, 柴爾青. 急性腦出血合并肺部感染患者病原菌分布、藥敏性及血清PCT、hs-CRP水平分析. 中國病原生物學雜志, 2019, 14(8): 952-954, 979.
4. 朱夢莉, 彭麗清, 袁光新, 等. SIRS 標準與 SOFA 和 qSOFA 評分對急診疑似感染患者的預后預測價值. 中華醫院感染學雜志, 2019, 29(19): 2894-2898.
5. Ratzinger F, Haslacher H, Perkmann T, et al. Sepsis biomarkers in neutropaenic systemic inflammatory response syndrome patients on standard care wards. Eur J Clin Invest, 2015, 45(8): 815-823.
6. Weiss SL, Fitzgerald JC, Pappachan J, et al. Global epidemiology of pediatric severe sepsis: the sepsis prevalence, outcomes, and therapies study. Am J Respir Crit Care Med, 2015, 191(10): 1147-1157.
7. Lee H. Procalcitonin as a biomarker of infectious diseases. Korean J Intern Med, 2013, 28(3): 285-291.
8. 伍方紅, 許得澤, 韋繼政, 等. 降鈣素原及C反應蛋白檢測在術后重度膿毒血癥患者預后判斷中的意義. 廣東醫學, 2013, 34(9): 1369-1371.
9. Haubitz S, Mueller B, Schuetz P. Streamlining antibiotic therapy with procalcitonin protocols: consensus and controversies. Expert Rev Respir Med, 2013, 7(2): 145-157.
10. Jain S, Sinha S, Sharma SK, et al. Procalcitonin as a prognostic marker for sepsis: a prospective observational study. BMC Res Notes, 2014, 23(7): 458-464.
11. Mat Nor MB, Md Ralib A. Procalcitonin clearance for early prediction of survival in critically ill patients with severe sepsis. Crit Care Res Pract, 2014, 32(8): 1903-1914.
12. 何健卓, 譚展鵬, 張敏州, 等. 血必凈注射液對嚴重膿毒癥患者血流動力學及內皮功能影響的前瞻性研究. 中華危重病急救醫學, 2015, 27(2): 127-132.
13. Kip MM, Kusters R, IJzerman MJ, et al. A PCT algorithm for discontinuation of antibiotic therapy is a cost-effective way to reduce antibiotic exposure in adult intensive care patients with sepsis. J Med Econ, 2015, 18(11): 944-953.
14. 鄭超, 喬陳財, 陳奕, 等. 菌血癥患者細菌感染程度與血清PCT、hs-CRP水平變化研究. 重慶醫科大學學報, 2017, 42(2): 240-243.
15. 李志英, 周軍. 聯合檢測血清sTREM-1、IL-17、hs-CRP在肺炎中的診斷價值. 中國老年學雜志, 2018, 38(17): 4167-4169.
16. 趙魯新, 仝冰云, 姜寧, 等. 血清IL-12與hs-CRP對新生兒感染性疾病的診斷效果研究. 中華醫院感染學雜志, 2019, 29(7): 1106-1108, 1112.
17. Brennan MB, Osterby K, Schulz L, et al. Impact of low procalcitonin results on antibiotic administration in hospitalized patients at a tertiary care center. Infect Dis Ther, 2016, 5(2): 185-191.
18. 李麗娟, 陳煒, 古旭云, 等. 血漿PCT和CRP水平的動態變化對膿毒癥嚴重程度的評估及其相關性研究. 中國實驗診斷學, 2013, 17(6): 1010-1013.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical value of PCT, WBC, and CRP in diagnosis of common bile duct stones with bile duct infection and systemic inflammatory response syndrome

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