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Changes in C-Reactive Protein and Complete Blood Cell Count According to Procalcitonin Levels
Korean J Clin Lab Sci 2022;54:15-22  
Published on March 31, 2022
Copyright © 2022 Korean Society for Clinical Laboratory Science.

Jin-San Kim1, Chang-Eun Park2

1Department of Laboratory Medicine, Gangnam CHA Hospital, Seoul, Korea
2Department of Biomedical Laboratory Science, Molecular Diagnostics Research Institute, Namseoul University, Cheonan, Korea
Correspondence to: Chang-Eun Park
Department of Biomedical Laboratory Science, Molecular Diagnostics Research Institute, Namseoul University, 91 Daehak-ro, Seonghwan-eup, Seobuk-gu, Cheonan 31020, Korea
E-mail: eun2777@hanmail.net
ORCID: https://orcid.org/0000-0003-4259-7928
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Procalcitonin (PCT) can provide an experimental rationale and a diagnostic lead to distinguish between bacterial and viral infections. This study sought to investigate the clinical characteristics and prognosis of patients with high PCT levels, to improve clinical diagnosis, and to determine whether PCT levels were associated with the subsequent development of sepsis in the general population. This was a retrospective observational study conducted on outpatients (N=127) over a year. The general data and laboratory parameters studied were PCT, C-reactive protein (CRP), and complete blood count (CBC). The positive rates of CRP and white blood cells (WBCs) in the elevated PCT group were higher than those of the normal group (P<0.05); the specificity and sensitivity of the PCT levels were obviously higher than those of the CRP and WBC levels at diagnosis (P<0.05). The mean PCT levels in the low group were significantly higher than those in the high or moderate group (P<0.001). There was a significant positive correlation with CRP, total WBCs, and neutrophils (P<.001). The main finding of this study was the significant association between an elevated PCT level and CRP and WBC levels, signifying a high diagnostic value. This has important implications for the diagnosis of bacterial infections and therapeutic implications for the use of antibiotic treatment in specific patients.
Keywords : Complete blood count, C-reactive protein, Neutrophil, Procalcitonin, Sepsis
INTRODUCTION

Sepsis is a life-threatening syndrome arising from the host's extreme and dysregulated inflammatory response primarily to bacterial infections. Procalcitonin (PCT) has been recommended and widely used for the prognosis, diagnosis, and monitoring of sepsis. Although many biomarkers were evaluated for the diagnosis and prognosis in sepsis, until now not one has been proven to be absolutely reliable in the clinical field. Currently, the C-reactive protein (CRP) and PCT were used worldwide laboratory. nevertheless their values may elevate in clinical settings without sepsis, while they often fail to provide reliable prediction of the patient outcome [1].

Early identification of bacterial infections in patients with chronic liver disease is sometimes challenging. The clinical presentation is usually atypical, and the leukocyte count is difficult to interpret due to chronic hypersplenism with pancytopenia [2]. Elevated serum PCT levels do not discriminate between the major categories of shock. However, a normal serum PCT eliminates a bacterial etiology of the shock in more than 95% of patients [3].

In patients with CAP (community acquired pneumonia), molecular diagnostics can rapidly detect potential viral and bacterial pathogens. The PCT can help clarify if a detected bacterial pathogen is colonizing or invading. As a consequence, empiric therapy can become specific therapy in an increasing number of patients. The biomarkers analyzed were procalcitonin levels, white blood cell count (WBC), CRP levels, and platelet (PLT) count. Taylor et al were focus specifically on the results that directly relate to the diagnostic accuracy of procalcitonin in predicting blood cultures [4]. The PBC-PCI (peripheral blood cells-percutaneous coronary intervention) study found that patients with a positive blood culture had significantly higher values of procalcitonin.

Reliable clinical or microbiological parameters to establish or refute the diagnosis of a bacterial infection of the respiratory system have largely been lacking [5]. Current microbiological methods are still plagued by significant delays and low sensitivity (e.g., blood culture) or low specificity due to possible contamination and colonization (e.g., sputum culture) [6]. This being the case, the inflammatory blood marker PCT has stimulated great interest as a more specific blood biomarker for bacterial infections [7]. In addition, the rising levels of PCT bear a close relationship with the morbidity of infectious diseases. CRP is an inflammatory marker and directly participates in the inflammatory process. A comparison of laboratory examination between PCT and patients was performed.

A combination of factors including WBC counts, the percentage of immature forms of neutrophils (or bands), and CRP show modest usefulness. Even in combination, the biomarker with better predictive value for bacterial infection is essential to inform clinical practice. PCT is a biochemical marker that holds great promise for the management of infectious diseases, particularly infections of the respiratory tract and sepsis. We performed a retrosepective systematic review of the available to assess the accuracy of PCT for the diagnosis of sepsis in adult patients and compared the performance between CRP, complete blood count (CBC), and PCT.

Therefore, we conducted this systematic review not only to pool the results from relevant database, but also to compare the diagnostic accuracy of other biomarkers in diagnosis. We aimed to generate a more comprehensive understanding of the diagnostic performance and potential influence factors of procalcitonin in distinguishing sepsis.

MATERIALS AND METHODS

1. Subjects

This was a retrospective cohort study conducted on data from the PCT, CBC and CRP in CHA general hospital, which is the most recent data that measured. The PCT group was determined using standard laboratory techniques on a Cobas8000 modular analyzer (Roche Diagnostic International AG, Rotkreuz, Switzerland). CRP was measured by Cobas8000 modular (particle enhanced immunoturbidimetric assay), CBC and WBC-Diff were measured by Sysmex XE-2100 (Sysmex, Kobe, Japan). these data were a cross-sectional survey conducted by outpatients in CHA general hospital. These were performed from January 2016 to December 2016. Among the 127 subjects who participated in the outpatients. This study has been conducted according to the principles expressed in the Declaration of Helsinki (approved and exemption by Institutional Review Board No. 1041479-201705-HR-010 at N University).

2. General characteristics

Patients were excluded if they had received antibiotic therapy for over 48 hours at the time the PCT level was obtained, if cultures (ie, blood, urine, cerebral spinal fluid, sputum, wound) were not obtained within 24 hrs of PCT values, Clinical and demographic data collected from the laboratory database. Any available biomarker information collected within 24 hrs of a PCT sample was collected including WBC counts and CRP. Data related to antibiotic administration within 24 hrs of the PCT draw included the choice of antibiotic, The Elecsys BRAHMS PCT assay (on Roche COBAS modular analyzer) is designed to provide full automation, which means no reagent preparation or hands-on testing is required. This fast, reliable assay offers same-day testing capability with a short incubation time of only 18 minutes. It also has a broad measuring range (0.02∼100 ng/mL, extending to 400 ng/mL with a recommended 1:4 dilution).

3. Statistical analysis

The level of statistical significance was defined as having a P-value of less than 0.05 or 0.01. Data were analyzed using PASW version 17.0 (SPSS Inc., Chicago, IL, USA). Categorical variables were reported as percentages and compared using the chi-square or Fisher’s exact test as appropriate.

RESULTS

1. The comparison of parameters in clinical patients

A total of the 127 participants tested for various parameters. The PCT (1.4±5.46) and CRP (6.3±7.73) levels of patients were higher than reference value. Also, Other factors were detected normal range values (Table 1).

Mean score of parameters (N=127)

Variables Min Max Mean SD Reference value
PCT (ng/mL) 0.05 45.9 1.4 5.46 <0.05 ng/mL
CRP (mg/dL) 0.02 32.4 6.3 7.73 <0.30 mg/dL
WBC (103 μL) 1.5 26.8 10.5 5.10 4.000∼10.000/μL

Abbreviations: PCT, procalcitonin; CRP, C-reactive protein.



To comparison analysis parameters levels between normal range group and abnormal group. The PCT, CRP and WBC factors were highly than normal groups. and the differences were statistically significant (P< 0.001). The PCT factor and was highly than normal groups. and the differences were statistically significant (P<0.005). The lymphocyte were highly than normal groups. and the differences were statistically significant (P<0.05) as shown in Table 2.

Comparison of parameters levels between normal and abnormal group (N=127)

Characteristics Cutoff (reference value) N (%) Mean±SD F (P) value
PCT Normal (<0.05 ng/mL)
Abnormal (>0.05 ng/mL)
34 (26.8)
93 (73.2)
0.05±0.00
1.91±6.31
7.862 (0.005)*
CRP Normal (<0.30 mg/dL)
Abnormal (>0.30 mg/dL)
22 (17.3)
105 (82.7)
0.08±0.07
7.64±7.90
39.513 (0.001)*
Blood culture No growth
Growth
119 (93.7)
8 (6.3)
WBC Normal (4.000∼10.000/μL)
Abnormal
56 (44.1)
71 (55.9)
6.7±1.81
13.5±4.89
17.712 (0.001)*
Neutrophil Normal (43∼75%)
Abnormal
58 (45.7)
69 (54.3)
61.6±10.03
61.2±27.86
163.105 (0.906)
Lymphocyte Normal (24∼45%)
Abnormal
35 (27.6)
92 (72.4)
33.4±7.72
26.7±23.31
42.905 (0.015)*
Monocyte Normal (2∼10%)
Abnormal
107 (84.3)
20 (15.7)
7.0±2.15
9.3±6.17
75.749 (0.102)
Eosinophil Normal (0∼6%)
Abnormal
125 (98.4)
2 (1.6)
1.1±1.43
11.8±4.03
7.577 (0.166)

Abbreviation: See Table 1.



2. The comparison of parameters in procalcitonin levels and blood culture growth status patients

Statistical analysis of several factors in the normal and abnormal groups of PCT. The CRP, WBC and RDW were statistically highly significant (P<0.001). In addition, Hemoglobin was statistically significant in the normal and abnormal groups (P<0.05) (Table 3). As a results of blood cultures showed that bacteria were identified and unidentified. the WBC was statistically significant in growth than no growth groups (P<0.05) (Table 4).

Mean score of parameters according to PCT levels status (Mean±SD)

Variables Normal (N=34) Abnormal (N=93) F (P) value
CRP (mg/dL) 2.6±3.77 7.6±8.34 23.746 (0.001)*
WBC (103 μL) 8.0±2.79 11.4±5.46 10.393 (0.001)*
HGB (g/dL) 12.6±1.33 11.9±1.72 1.644 (0.041)*
RDW (%) 12.6±0.85 13.3±1.56 5.147 (0.001)*

Abbreviations: HGB, hemoglobin; RDW, red blood cell distribution width.

*P<0.05


Mean score of parameters according to blood culture growth status (Mean±SD)

Variables No growth (N=119) Growth (N=8) F (P) value
PCT (mg/dL) 0.9±4.53 7.9±11.81 21.310 (0.142)
CRP (mg/dL) 5.8±7.18 13.5±11.91 6.278 (0.112)
WBC (103 μL) 10.0±4.67 16.8±7.17 4.093 (0.032)*
HGB (g/dL) 12.2±1.62 11.3±1.89 1.115 (0.155)
RDW (%) 13.1±1.40 14.0±1.82 2.136 (0.094)

Abbreviation: See Table 1, 2.

*P<0.05



3. Difference of parameters according to thirds grade procalcitonin

Statistical analysis of changes in the normal and abnormal groups of the parameters according to the quartile of procalcitonin, the difference CRP and WBC were statistically significant (P<0.01). The MCV, neutrophil and lymphocyte were statistically significant in normal and abnormal groups (P<0.05) (Table 5).

Difference of parameters in according to the level of procalcitonin

Variables Category Total
(N=127)
Q∼.30a (N=42) Q.31∼.70b (N=43) Q.71∼c (N=42) χ2 P
CRP (mg/dL) N 22 (17.3) 13 (10.2) 8 (6.3) 1 (0.8) 12.044 0.002*
ABN 105 (82.7) 29 (22.8) 35 (27.6) 41 (32.3)
WBC (103 μL) N 56 (44.1) 28 (22.1) 14 (11.0) 14 (11.0) 12.975 0.002*
ABN 71 (55.9) 14 (11.0) 29 (22.8) 28 (22.1)
HGB (g/dL) N 76 (59.8) 31 (24.4) 24 (18.9) 21 (16.5) 5.393 0.067
ABN 51 (40.2) 11 (8.7) 19 (15.0) 21 (16.5)
MCV (fL) N 85 (66.9) 34 (26.8) 24 (18.9) 27 (21.2) 6.264 0.044*
ABN 42 (33.1) 8 (6.3) 19 (15.0) 15 (11.8)
RDW (%) N 97 (76.4) 34 (26.8) 32 (25.2) 31 (24.4) 0.732 0.693
ABN 30 (23.6) 8 (6.2) 11 (8.7) 11 (8.7)
Neutrophil (%) N 58 (45.7) 26 (20.5) 18 (14.2) 14 (11.0) 7.289 0.026*
ABN 69 (54.3) 16 (12.6) 25 (19.7) 28 (22.0)
Lymphocyte (%) N 35 (27.6) 18 (14.2) 11 (8.7) 6 (4.7) 8.714 0.013*
ABN 92 (72.4) 24 (18.9) 32 (25.2) 36 (28.3)
Monocyte (%) N 107 (84.3) 37 (29.1) 38 (29.9) 32 (25.3) 3.075 0.215
ABN 20 (15.7) 5 (3.9) 5 (3.9) 10 (7.9)
Eosinophil (%) N 125 (98.4) 41 (32.2) 42 (33.1) 42 (33.1) 1.004 0.605
ABN 2 (1.6) 1 (0.8) 1 (0.8) 0 (0)
Basophil (%) N 127 (100.0) 42 (33.1) 43 (33.8) 42 (33.1)
ABN 0 (0) 0 (0) 0 (0) 0 (0)

Abbreviations: See Table 1, 2; N, normal; ABN, abnormal; RDW, red cell distribution width.



As a results of statistical significance with the parameters according to the quartile of procalcitonin, the PCT, CRP, WBC and lymphocyte were statistical significance in low, middle, high groups (P<0.005). Also, the segment neutrophil was statistical significance higher than lower groups (P<0.01) (Table 6).

Difference of parameters in according to the third grade of procalcitonin levels (Mean±SD)

Variables Total
(N=127)
Q∼.30a (N=42) Q.31∼.70b (N=43) Q.71∼c (N=42) F (P) Schéffe* (P)
PCT (ng/mL) 1.4±5.46 0.05±0.01 0.1±0.05 4.1±8.97 8.550 (0.000) a<c, b<c
CRP (mg/dL) 6.3±7.73 2.6±3.68 4.1±5.70 12.2±9.07 26.060 (0.000) a<c, b<c
WBC (103 μL) 10.5±5.10 8.2±2.90 11.2±5.14 12.1±5.99 7.472 (0.001) a<c, b<c
HGB (g/dL) 12.1±1.64 12.5±1.55 12.0±1.57 11.9±1.77 1.807 (0.168)
MCV (fL) 82.8±7.08 85.6±6.43 81.0±6.80 82.0±7.31 5.248 (0.006) b<a
RDW (%) 13.1±1.44 12.7±1.00 13.3±1.21 13.5±1.89 3.162 (0.046)
Neutrophil (%) 61.4±21.55 58.9±20.17 55.7±23.42 69.7±18.64 5.218 (0.007) b<c
Lymphocyte (%) 28.5±20.44 31.8±19.61 33.4±22.55 20.3±16.51 5.568 (0.005) a<c, b<c
Monocyte (%) 7.3±3.22 6.9±2.77 7.3±2.93 7.8±3.87 0.827 (0.440)
Eosinophil (%) 1.3±1.98 1.5±1.84 1.8±2.63 0.7±0.95 3.831 (0.024) c<b

Abbreviation: See Table 5.

*P<0.001.



4. Correlation of parameters

Table 7 showed the significant correlation between the total parameters. The 16 subscales of parameters, showed a significant positive correlation with CRP, WBC, neutrophil scores. the procalcitonin showed a significant negative correlation with HGB, PLT, lymphocyte, monocyte scores.

Correlation of parameters (r(p))

  A B C D E F G H I J K L M N O P
PCT 1
CRP 0.285**
(0.001)
1
WBC 0.039
(0.663)
0.379**
(0.000)
1
HGB −0.131
(0.143)
−0.079
(0.377)
0.026
(0.773)
1
HCT −0.161
(0.071)
−0.094
(0.291)
−0.022
(0.804)
0.974**
(0.000)
1
MCV −0.047
(0.602)
0.289**
(0.001)
0.005
(0.958)
−0.120
(0.179)
−0.109
(0.223)
1
MCH −0.012
(0.893)
0.291**
(0.001)
0.081
(0.363)
0.058
(0.514)
−0.006
(0.946)
0.932**
(0.000)
1
MCHC 0.074
(0.411)
−0.142
(0.111)
−0.034
(0.703)
0.180*
(0.043)
0.057
(0.528)
−0.117
(0.190)
0.091
(0.310)
1
RDW 0.019
(0.831)
0.206*
(0.020)
0.063
(0.480)
−0.342**
(0.000)
−0.241**
(0.006)
−0.200*
(0.024)
−0.376**
(0.000)
−0.356**
(0.000)
1
PLT −0.173
(0.052)
−0.179*
(0.044)
0.246**
(0.005)
−0.184*
(0.038)
−0.171
(0.054)
−0.041
(0.647)
−0.084
(0.348)
−0.086
(0.337)
0.071
(0.429)
1
PDW 0.112
(0.209)
0.162
(0.068)
−0.044
(0.620)
−0.014
(0.871)
0.035
(0.695)
0.208*
(0.019)
0.124
(0.165)
−0.170
(0.056)
0.044
(0.621)
−0.241**
(0.006)
1
Neu 0.175*
(0.049)
0.528**
(0.000)
0.377**
(0.000)
0.005
(0.953)
0.005
(0.959)
0.297**
(0.001)
0.296**
(0.001)
−0.103
(0.249)
0.137
(0.125)
−0.217*
(0.014)
0.010
(0.910)
1
Lym −0.178*
(0.046)
−0.513**
(0.000)
−0.313**
(0.000)
0.013
(0.885)
0.011
(0.905)
−0.328**
(0.000)
−0.320**
(0.000)
0.104
(0.244)
−0.125
(0.161)
0.222*
(0.012)
−0.193*
(0.030)
−0.960**
(0.000)
1
Mono −0.227*
(0.010)
−0.144
(0.105)
−0.057
(0.524)
0.008
(0.928)
−0.016
(0.857)
−0.007
(0.939)
0.036
(0.685)
0.107
(0.231)
0.017
(0.853)
0.172
(0.054)
−0.272**
(0.002)
−0.274**
(0.002)
0.232**
(0.009)
1
Eos −0.116
(0.195)
−0.128
(0.150)
−0.236**
(0.008)
−0.110
(0.216)
−0.119
(0.184)
0.023
(0.793)
0.023
(0.801)
0.055
(0.540)
0.074
(0.406)
0.136
(0.127)
−0.079
(0.377)
−0.219*
(0.013)
0.158
(0.076)
0.053
(0.553)
1
Baso −0.077
(0.389)
−0.045
(0.616)
−0.118
(0.185)
−0.170
(0.056)
−0.151
(0.089)
0.112
(0.211)
0.050
(0.573)
−0.087
(0.332)
0.079
(0.378)
0.049
(0.582)
0.002
(0.985)
−0.047
(0.602)
0.035
(0.694)
0.008
(0.927)
0.214*
(0.016)
1

Abbreviations: See Table 1, 2, 5; A, PCT; B, CRP; C, WBC; D, HGB; E, HCT; F, MCV; G, MCH; H, MCHC; I, RDW; J, PLT; K, PDW; L, Neu; M, Lym; N, Mono; O, Eos; P, Baso.

**P<0.01; *P<0.05.


DISCUSSIONS

In this study provides a scientific guidance for a diagnosis through investigating values of PCT, CRP and CBC levels in the diagnosis and its relationship and discovering for a high-efficient and effective laboratory method is of great clinical significance to the diagnosis of bacterial infection and sepsis. In this context, the biomarkers for acute inflammatory response, such as CRP and PCT may prove useful in the early stages of sepsis before positive microbiological identification can be obtained [8]. The increase in PCT serum levels occurred several hours earlier than the increase in CRP concentration.

The available data support that both PCT and CRP have a high accuracy in differentiating bacterial from other noninfective cause of inflammation in patients with liver cirrhosis. However, both PCT and CRP are far from being a “gold standard” test. Additional studies are needed to determine if serum levels of PCT or CRP are related to mortality or complications and whether they can be used safely and effectively for antibiotics stewardship [9]. PCT levels remain low with a pure viral infection and increase with either a pure bacterial or a mixed viral-bacterial infection. PCT was released ubiquitously in response to endotoxin and other mediators secreted during bacterial infections (e.g., interleukin-[IL]-1β, tumor necrosis factor [TNF]-α, and IL-6) [10]. Its levels thus strongly correlate with the extent and severity of bacterial infections [11].

Upregulation of PCT expression is attenuated by interferon-gamma (INF-γ), a cytokine released during viral infections [12]. These characteristics make PCT more specific for bacterial infections than markers such as WBC or CRP, and may allow PCT to be used in differentiating bacterial from viral infections and other non-infectious illnesses [13]. The RT-PCR test offered similar diagnostic performance to procalcitonin in some subgroups but offered better discrimination in others such as viral vs. non-infectious illness and bacterial/viral coinfection [14]. The use of biomarkers in pediatric sepsis is promising, although such use should always be correlated with clinical evaluation. Biomarkers may also improve the prediction of mortality, especially in the early phase of sepsis, when the levels of certain pro-inflammatory cytokines and proteins are elevated [15].

PCT shows a favorable kinetic profile that makes it well suited for use as a clinical marker: circulating levels increase promptly (within 6∼12 hrs) upon stimulation and halve daily when the bacterial infection is controlled by the host immune system or through antibiotic therapy. In normal stage, serum CRP levels is so low that it nearly cannot be detected; however, in the pathological state of infection, especially in acute stage, endogenous transmitters released by WBC accelerate hepatocyte to synthesize CRP in 4∼6 hrs after the occurrence of infection, which results in the sudden increase of CRP level in serum; in 36∼50 hrs after the occurrence of infection, serum CRP level reaches the peak value which is 100∼1,000 times as high as normal value.

This study found that elevated PCT levels was relation to CRP and WBC. it indicated to the quartile of PCT, the difference CRP, WBC were statistically significant (P< 0.01). PCT was more sensitive than CRP and WBC in the early stage of bacterial infection. Importantly, multiple studies have observed PCT to be highly associated with bacteremia (the main diagnostic criteria for endocarditis) in Emergency Department patients with fever [16].

PCT is also an interesting marker for differentiating between respiratory and cardiovascular acute illness. There is observational evidence and data from secondary analyses of randomized trials, suggesting that PCT testing may help to direct antibiotic treatment in such patients, but evidence from larger prospective, interventional trials is currently lacking [17].

There were some limitations for our study. First, most studies we included diagnosed sepsis using reference standard from clinical patients or different compositions of control groups (healthy control, mixed etc.) were compared in the subgroup analysis. Second, the timing of biomarker measurements and different specimen types were taken into account in the analysis. Third, Clinical trials are still needed to reevaluate the performance and the optimal cut-off of procalcitonin accordingly. Fourth, the statistical power might still be not enough to confirm the diagnostic value of procalcitonin.

Additionally, it cannot be recommended as a single test for sepsis diagnosis, but may be useful in combination with some sensitive biological markers. In addition, continuing re-evaluation during the course of sepsis is advisable. The inflammatory blood marker PCT aids in the diagnosis of bacterial infection and appropriate antibiotic treatment. Implementation of PCT in patients can guide clinical decisions to diagnose bacterial infections early on to reduce unnecessary tests, procedures, and hospital stay length [18]. There is a need for further research to determine whether or not the routine use of procalcitonin should be used in settings other than the emergency department. The detection of PCT, CRP and WBC levels can provide valuable reference for the early accurate diagnosis, effective and reasonable treatment and favorable prognosis.

요 약

프로칼시토닌(procalcitonin, PCT)은 세균성과 바이러스성의 감염을 구별하기 위한 과학적 근거와 진단상의 중요한 단서를 제공한다. 프로칼시토닌이 높은 환자의 임상적 특성과 예후를 조사하고 임상적 진단을 향상시키고자 한다. 프로칼시토닌이 일반적인 집단에서 패혈증의 유병률과 연관성이 있는지를 결정한다. 이에 본 연구는 1년 동안 프로칼시토닌을 검사한 외래 환자(127명)의 C-반응성단백과 혈구산정검사의 결과를 기반으로 후향적 조사연구이다. 분석에 사용된 데이터는 프로칼시토닌, C-반응 단백 그리고 혈구산정검사이다. PCT의 결과가 높은 군의 CRP와 WBC의 양성율은 정상군보다 높게 나타났다(P<0.05). 프로칼시토닌 수준의 특이성과 민감도는 C-반응단백과 백혈구 수준보다 높게 나타났다(P<0.05). 또한. 프로칼시토닌의 결과값을 삼분위한 그룹의 분석에서는 낮은 군과 중간군의 값에 비해 높은 군의 값이 평균보다 높은 것으로 나타났다(P< .001). 상관분석에서는 프로칼시토닌은 C-반응단백, 백혈구(호중구, 림프구 포함)에서 양의 상관성을 보였다(P<.001). 이 연구의 주된 발견은 높은 프로칼시토닌은 C-반응성단백, 백혈구들의 수준에서 높은 연관성을 보이며 진단적 가치를 확인하였다. 따라서 이러한 관련 인자들은 환자의 감염진단과 항생제 치료에 중요한 진단적 및 치료적 영향을 미칠 것으로 사료된다.

Acknowledgements

None

Conflict of interest

None

Author’s information (Position)

Kim JS1, M.T.; Park CE2, Professor.

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