DIAGNOSTIC AND PROGNOSTIC VALUES OF COMBINED DETECTION OF PCT, CRP, STREM-1 AND SCD163 FOR SEVERE PNEUMONIA

Liu Xin1, Li Bin1, Liu Jian2, *

1Department of ICU, The First Hospital of Lanzhou University, No. 1 Donggang West Road, Lanzhou City, Gansu Province 730000 2The First Hospital of Lanzhou University, No. 1 Donggang West Road, Lanzhou City, Gansu Province 730000

 Objective: To investigate the diagnostic and prognostic values of combined detection of procalcitonin (PCT), C-reactive protein (CRP), soluble triggering receptor expressed on myeloid cell-1 (sTREM-1) and soluble hemoglobin scavenger receptor (sCD163) for severe pneumonia.

Methods: Patients with pneumonia (75) treated in our hospital from May 2014 to July 2015 were selected and divided into severe pneumonia group (n=52) and mild pneumonia group (n=23). The severe pneumonia group was further divided into two subgroups: survival group (n=31) and death group (n=21). A group of 30 healthy examinees were used as control. The patients were routinely tested for PCT and CRP after admission, and sTREM-1 and sCD163 levels were measured using enzyme-linked immunosorbent assay (ELISA). Changes in PCT, CRP, sTREM-1 and sCD163 levels in the severe pneumonia group were determined at various time points, e.g. post- admission, 1st, 4th and 7th days, and on discharge and death days.

Results: The levels of PCT, CRP, sTREM-1, and sCD163 among three groups (in a descending order) were severe pneumonia group > mild pneumonia group > control group (p<0.01). The PCT, CRP, sTREM-1, and sCD163 levels in survival group showed a decreasing trend with time, and the levels of PCT, CRP, and sTREM-1 on the day of discharge were significantly lower than the corre- sponding levels on admission, 1st, 4th and 7th days (p<0.01). The PCT, CRP and sTREM-1 levels in the death group remained high, while the sCD163 level increased with time. At death, PCT, CRP, sTREM-1 and sCD163 levels were significantly higher than those on admission, 1st, 4th and 7th days (p<0.01). The levels of PCT, CRP, sTREM-1, and sCD163 in the death group were significantly higher than those in the survival group (p<0.01). The ROC curve analysis showed that the AUC of PCT and CRP were lower (0.840 and 0.814, respectively) than the AUC of sTREM-1 and sCD163 (0.909 and 0.863, respectively). The AUC of sCD163+sTREM-1 was the highest (0.936) (95 % CI = 0.885, 0.987). Correlation analysis showed positive correlation between sTREM-1 and sCD163 (r=0.623, p<0.01).

Conclusion: PCT, CRP, sTREM-1 and sCD163 reflect the severity of pneumonia and have important diagnostic values. There- fore, the combined monitoring of the four indicators is necessary for prediction of prognosis, and may be potentially valuable predic- tors of severe pneumonia.