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.	崔晓婷, 郑红晓, 李海燕, 等. 血清BNP与hs-CRP和PCT对慢性心力衰竭患者肺部感染的诊断评价. 中华医院感染学杂志, 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.	刘倩, 虎亚光, 柴尔青. 急性脑出血合并肺部感染患者病原菌分布、药敏性及血清PCT、hs-CRP水平分析. 中国病原生物学杂志, 2019, 14(8): 952-954, 979.
4.	朱梦莉, 彭丽清, 袁光新, 等. SIRS 标准与 SOFA 和 qSOFA 评分对急诊疑似感染患者的预后预测价值. 中华医院感染学杂志, 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.	伍方红, 许得泽, 韦继政, 等. 降钙素原及C反应蛋白检测在术后重度脓毒血症患者预后判断中的意义. 广东医学, 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, 谭展鹏, 张敏州, 等. 血必净注射液对严重脓毒症患者血流动力学及内皮功能影响的前瞻性研究. 中华危重病急救医学, 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.	郑超, 乔陈财, 陈奕, 等. 菌血症患者细菌感染程度与血清PCT、hs-CRP水平变化研究. 重庆医科大学学报, 2017, 42(2): 240-243.
15.	李志英, 周军. 联合检测血清sTREM-1、IL-17、hs-CRP在肺炎中的诊断价值. 中国老年学杂志, 2018, 38(17): 4167-4169.
16.	赵鲁新, 仝冰云, 姜宁, 等. 血清IL-12与hs-CRP对新生儿感染性疾病的诊断效果研究. 中华医院感染学杂志, 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.	李丽娟, 陈炜, 古旭云, 等. 血浆PCT和CRP水平的动态变化对脓毒症严重程度的评估及其相关性研究. 中国实验诊断学, 2013, 17(6): 1010-1013.

1. 崔晓婷, 郑红晓, 李海燕, 等. 血清BNP与hs-CRP和PCT对慢性心力衰竭患者肺部感染的诊断评价. 中华医院感染学杂志, 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. 刘倩, 虎亚光, 柴尔青. 急性脑出血合并肺部感染患者病原菌分布、药敏性及血清PCT、hs-CRP水平分析. 中国病原生物学杂志, 2019, 14(8): 952-954, 979.
4. 朱梦莉, 彭丽清, 袁光新, 等. SIRS 标准与 SOFA 和 qSOFA 评分对急诊疑似感染患者的预后预测价值. 中华医院感染学杂志, 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. 伍方红, 许得泽, 韦继政, 等. 降钙素原及C反应蛋白检测在术后重度脓毒血症患者预后判断中的意义. 广东医学, 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, 谭展鹏, 张敏州, 等. 血必净注射液对严重脓毒症患者血流动力学及内皮功能影响的前瞻性研究. 中华危重病急救医学, 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. 郑超, 乔陈财, 陈奕, 等. 菌血症患者细菌感染程度与血清PCT、hs-CRP水平变化研究. 重庆医科大学学报, 2017, 42(2): 240-243.
15. 李志英, 周军. 联合检测血清sTREM-1、IL-17、hs-CRP在肺炎中的诊断价值. 中国老年学杂志, 2018, 38(17): 4167-4169.
16. 赵鲁新, 仝冰云, 姜宁, 等. 血清IL-12与hs-CRP对新生儿感染性疾病的诊断效果研究. 中华医院感染学杂志, 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. 李丽娟, 陈炜, 古旭云, 等. 血浆PCT和CRP水平的动态变化对脓毒症严重程度的评估及其相关性研究. 中国实验诊断学, 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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