VALUE OF EARLY DIAGNOSIS OF STROKE-RELATED PNEUMONIA IN SERUM SCD163, C-REACTIVE PROTEIN, LEUKOCYTES, PROCALCITONIN AND CLINICAL PULMONARY INFECTION SCORING SYSTEM

Zhu Tian, Yanmin Wang, Huancheng Wu, Shijun Zhang, Qunliang Hu^*

Department of Neuro Intensive Care Unit, Tianjin Beichen Hosipital, Tianjin, PR China

Objective: To study the value of serum soluble scavenging receptor 163 (sCD163), C-reactive protein (hs-CRP), leukocyte (WBC), procalcitonin (PCT) and clinical pulmonary infection scoring system (CPIS) in the early diagnosis of stroke-associated pneumonia ((SAP)). 

Methods: From October 2018 to October 2019, 158 patients with SAP were divided into mild group (n=90) and severe group (n=68) according to their condition. 30 healthy people selected at the physical examination center at the same time were selected as the control group. The general data of age, sex, type of stroke and previous history of stroke were collected and all the subjects were scored by CPIS score. The fasting venous blood of the subjects was 5ml, the level of sCD163 was measured by double antibody sandwich enzyme-linked immunosorbent assay (Elisa), the level of WBC was measured by automatic biochemical analyzer, the level of hs-CRP was detected by hypersensitive latex enhanced immunoturbidimetry, and the level of serum PCT was detected by electrochemical luminous method. The value of SAP was judged by ROC curve analysis of sCD163, hs-CRP, WBC, PCT and CPIS score. 

Results: The levels of sCD163, hs-CRP,WBC,PCT and CPIS in mild group and severe group were higher than those in control group, and the sCD163, hs-CRP, WBC, PCT level and CPIS score in severe group were significantly higher than those in mild group (P<0.05). The sCD163, hs-CRP, WBC, PCT level and CPIS score in the death group were significantly higher than those in the survival group (P<0.05). Multivariate Logistics regression analysis showed that sCD163, hs-CRP, WBC, PCT and CPIS scores were independent risk factors for prognosis of patients with SAP (P<0.05). Roc curve analysis showed that the AUC of sCD163 in the diagnosis of SAP was 0.889, the best cut-off value was 1.56 mg/l, and the sensitivity and specificity were 79.26% and 78.22%, respectively. The AUC of hs-CRP in the diagnosis of SAP was 0.725, the best cut-off value was 68.13 mg/l, sensitivity and specificity was 66.42% and 69.26%, respectively. The AUC of SAP in the diagnosis of WBC was 0.652, the best cut-off value was 12.11×109 mg/l, sensitivity and specificity was 58.58% and 68.25%, respectively. The AUC of PCT in the diagnosis of SAP was 0.606. And the sensitivity and specificity of PCT were 53.18%, 67.43% and 6.00, respectively. The sensitivity and specificity of this point were 62.44% and 68.18%, respectively. The AUC of SAP was 0.778%, the best cut-off value was 6.00, and the sensitivity and specificity of this point were 62.44% and 68.18%, respectively. 

Conclusion: the level of sCD163, hs-CRP, WBC, PCT and the score of sCD163, hs-CRP, WBC, PCT in patients with SAP are significantly higher than those in healthy people. SCD163, hs-CRP, WBC, PCT and CPIS scores are valuable in the diagnosis of SAP, and the diagnostic value of sCD163 is better than that of hs-CRP, WBC, PCT and CPIS, which plays an important role in the diagnosis of SAP.