ObjectiveTo explore procalcitonin (PCT) dynamically in severe community-acquired pneumonia (SCAP) patients to evaluate the effects of different kinds of medical treatments and assess the clinical significance of the change of PCT. MethodsAll of the selected 60 SCAP patients treated from January 2009 to April 2011 met the standards of IDSA/ATS Guidelines for CAP. There were 38 males and 22 females, with an average age of 66.3 years. The sterile venous blood specimen samples were collected from the patients at day 0 to day 5. PCT and C-reactive protein (CRP) were measured by enzyme linked immunosorbent assay throughout the research. At day six, based on oxygenation index (PaO2/FiO2) ratio higher than 250, inflammation absorption on chest X ray after vasoactive agents were stopped, Glasgow scores higher than 10 and urine volume equal to or higher than 0.5 mL/(kg·d), we divided the patients into recovery group and deterioration group. Data were analyzed by SAS 9.0 software, and P<0.05 was considered to be statistically significant. ResultsThe analysis results showed that PCT and CRP bore a significantly positive relationship on day 0 (r=0.38, P=0.00). The research also indicated that PCT had a faster declining rate than CRP and white blood cells count throughout the clinical treatment. The average of PCT declined 29% in 48 hours. Following the criterion of PCT decrease by 30%, the research showed that PCT had a higher sensibility and specificity (66.87% and 85.50%, respectively) in 48 hours than 72 hours (70.05% and 100.00%), 96 hours (79.88% and 75.23%), and 120 hours (83.10% and 100.00%). ConclusionFollowing the criterion of PCT decrease by 30% after using antibiotics can be an clinical objective index to guide the use of antibiotics and provide the basis for clinical application and prognosis.
ObjectiveTo explore the distribution of mite allergens in chronic obstructive pulmonary disease (COPD) patients and the role of allergen in acute exacerbation of COPD (AECOPD) in Hainan Province. MethodsWe selected 65 COPD patients, 58 other patients without allergic disease and 34 healthy subjects as the control group from January to June in 2009. All subjects underwent skin prick test (SPT) to make statistical analysis. We observed the COPD patients for 3 years to analyze the correlation between SPT positive incidence and frequency of acute exacerbation. ResultsThe SPT positive incidence was higher in the COPD group (P<0.05). The most frequent allergen in COPD group was Blomia Tropicalis. But the SPT positive incidence and frequency of acute exacerbation was not obvious correlated (P>0.05). ConclusionThe exogenous allergens may participate in the pathogenesis of COPD. Blomia Tropicalis may be an important allergen of COPD patients in Hainan Province other than Dermatophagoides Pteronyssinus and Dermatophagoides Farinae. But allergy does not play a role in acute exacerbation of COPD.