Relationship between PCT, CRP, and IL-6 and postoperative delirium in ICU patients and its influencing factors.

Objective To explore the predictive values of serum procalcitonin (PCT) and C reactive protein (CRP) levels on coronary artery lesion (CAL) in acute phase of Kawasaki disease. Methods A total of 217 children with Kawasaki disease who hospitalized in Children′s Hospital of Chongqing Medical University from November 1, 2015 to December 31, 2016 were selected as research subjects. All the subjects have received standard Kawasaki disease treatments and all cases were in accord with the inclusion and exclusion criteria in this study. The gender, age, serum PCT and CRP levels, and echocardiographic findings within 30 d after the onset of Kawasake disease of all subjects were collected by retrospective method. According to children with acute Kawasaki disease complicated with CAL or not, they were divided into CAL group (n=22) and non-CAL group (n=29). Mann-Whitney U test was used to analyzed the differences of serum PCT and CRP levels between two groups. Chi-square test was used to compare the positive rates of serum PCT and CRP between two groups. Binary logistic regression analysis model was used to construct a new combined predictor L by serum PCT and CRP levels for predicting CAL in children with Kawasaki disease. And receiver operating characteristics (ROC) curves for new combined predictor L, serum PCR and CRP levels were built respectively, to evaluate the predictive values of combined predictor L and serum PCT, CRP levels on CAL in children with Kawasaki disease. The area under ROC curve (ROC-AUC) for combined predictor L and serum PCT, CRP levels in predicting CAL in children with Kawasaki disease all were calculated. The optimal cut-off point of combined predictor L and serum PCT, CRP levels predicting CAL in children with Kawasaki disease was obtained where the Youden index reached the maximum value. And diagnostic parameters such as sensitivity and specificity were also calculated for comparison.There were no statistically significant differences between two groups in the aspects of gender ratio, age, and so on (P>0.05). Results ①The medians of serum PCT level in CAL group and non-CAL group were 1.16 μg/L and 0.04 μg/L, respectively. The medians of serum CRP level in CAL group and non-CAL group were 25.0 mg/L and 16.4 mg/L, respectively. The levels of serum PCT and CRP in CAL group both were statistically higher than those in non-CAL group, and both the differences were statistically significant (Z=-2.454, P=0.046; Z=-6.412, P<0.001). There were no statistically significant differences in the positive rates of serum PCT and CRP between two groups (χ2=1.222, P=0.269; χ2=0.665, P=0.415). ②Binary logistic regression analysis model with complicated with CAL or not as a dichotomous outcome variable, and levels of serum CRP and PCT as independent variables showed that elevated levels of serum CRP and PCT were independent risk factors for children with Kawasaki disease complicated with CAL (OR=1.077, 95%CI: 1.027-1.190, P<0.001; OR=1.046, 95%CI: 1.015-1.078, P=0.003). The expression of combined predictor L was L=x1+ 0.608x2, in which x1 and x2 referred to the levels of serum CRP and PCT, respectively. ③ROC curve analysis indicated the values of ROC-AUC for combined predictor L, levels of serum PCT and CRP in predicting children with Kawasaki disease complicated with CAL were 0.773 (95%CI: 0.700-0.845, P<0.001), 0.560 (95%CI: 0.475-0.645, P=0.148), and 0.767 (95%CI: 0.695-0.839, P<0.001), respectively. The optimal cutoff values of combined predictor L, levels of serum PCT and CRP were 23.068, 2.32 μg/L, and 22.0 mg/L, respectively, and the sensitivities were 68.1%, 30.6% and 68.1%, respectively, the specialties were 83.4%, 86.9% and 80.7%, respectively. Conclusions Monitoring levels of serum PCT, CRP and combined predictor L (L=x1+ 0.608x2, x1 and x2 referred to levels of serum CRP and PCT, respectively) have predictive values to evaluate the occurrence of children with Kawasaki disease complicating CAL in acute phase. Key words: Procalcitonin; C reactive protein; Mucocutaneous lymph node syndrome; Coronary artery lesion; Predictive value; Combined predictive indicator; Logistic regression model; Child

Objective The aim of this study is to investigate the changes and significance of serum C-reactive protein (CRP) and procalcitonin (PCT) levels in patients with acute simple lower urinary tract infection (ALUTI) and to analyze the efficacy of treatment with Shuangdong capsules, so as to provide a basis for the rational clinical application of drugs. Methods 92 patients with ALUTI (observation group) were randomly divided into 46 cases each in group A and group B. Group A was treated with basic anti-infective drugs, while group B was treated with Shuangdong capsules, and the duration of treatment in both groups was 14 days. The curative effect of the two groups was analyzed, and the changes in serum PCT and CRP levels were compared before and after treatment and compared with 40 healthy people in the control group. Results The serum PCT and CRP levels, the number of urinary leukocyte count (LEU), and the number of urinary bacterial count (BACT) were significantly higher in Group A and Group B than in the healthy control group before treatment (P < 0.05). After treatment, the total clinical efficiency of patients in group B (97.83%) was significantly higher than that in group A (78.26%) (P < 0.05). The serum PCT and CRP levels, the number of urinary LEU, and the number of urinary BACT decreased in both groups after treatment compared with those before treatment, and all of them were significantly lower in group B than in group A (P < 0.05). The area under the curve (AUC) values of serum PCT and CRP levels for the diagnosis of acute simple lower urinary tract infection were 0.747 (95% CI 0.633–0.860) and 0.926 (95% CI 0.870∼0.982), both with high sensitivity and specificity. Conclusion The Shuangdong capsule combined with conventional antibacterial drugs has better clinical efficacy in the treatment of acute simple lower urinary tract infection; serum CRP and PCT levels in patients with acute simple lower urinary tract infection can be used as indicators for diagnosis and efficacy determination of the infection.

Objectives. Procalcitonin is a propeptide of calcitonin and has been increasingly used as a biomarker of infection. The aim of this study was to evaluate correlation of serum C-reactive protein (CRP) and procalcitonin (PCT) levels of kidney transplant patients hospitalized due to infection. Methods. There were 121 patients who had kidney transplant in our center between September 2012 and February 2017 and patients with a diagnosis of infection or rejection were included in the study. Simultaneous 106 serum CRP and PCT levels at the beginning or during any time of treatment for post-transplant infection, cytomegalovirus (CMV) positivity, BK virem ia and rejection were evaluated. Results. Median and interquartile ranges of CRP and PCT serum levels were 40 mg/l [24.7-64.9] and 0.19 ng/ml [0.1-0.61], respectively. A significant positive correlation between serum CRP and PCT levels of the patients were observed (r=0.490, p <0.001). When serum CRP levels were grouped as <50 mg/l, 50-100 mg/l and >100 mg/l, correlations with serum PCT levels were as r=0.461 ( p <0.001), r=-0.52 ( p =0.860) and r=0.488 ( p =0.153), respectively . Serum levels of PCT did not increase in CMV and BK virus infections and rejection. Conclusions. Serum CRP and PCT levels were correlated as a whole in the study, whereas serum CRP levels of 50-100 mg/l and >100 mg/l did not show a statistically significant correlation. Stability of PCT levels in viral infections and rejections might be an advantage for the follow-up of solid organ transplants. We need prospective trials of PCT measurements for the evaluation of post-transplant infections.

Objective To investigate the application value of sputum culture combined with serum erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and procalcitonin (PCT) levels in the diagnosis of lower respiratory tract infection. Methods Fifty-nine patients with lower respiratory tract infection in hospital were selected as study group, including 27 cases of bacterial infection, 32 cases of non-bacterial infection; and 58 healthy subjects were selected as the control group. Sputum specimens were callected from all patients and were cultured; and serum ESR, CRP, PCT level were detected. The levels of serum ESR, CRP and PCT were compared between the two groups. The levels of ESR, CRP and PCT in serum of patients with bacterial infection and non-bacterial infection were compared. The distribution of pathogens in the study group was statistically analyzed. The sputum cultures, serum levels of ESR, CRP and PCT were detected and the clinical outcome of lower respiratory tract infection was confirmed clinically. The clinical results were used as the gold standard to compare the results of sputum culture, serum ESR, CRP, PCT levels, single detection and combined detection of lower respiratory tract infections. Results The levels of serum ESR, CRP and PCT in the study group were higher than those in the control group, and the differences were significant (P<0.05). The levels of serum ESR, CRP and PCT in patients with bacterial infection were higher than those in patients with non bacterial infections, and the differences were significant (P<0.05). There were 178 pathogens in the study group, including 4 cases of fungi, accounting for 2.25%; 81 cases of gram negative bacteria, accounting for 45.51% and 93 cases of gram positive bacteria, accounting for 52.24%. The sensitivity, specificity and accuracy of sputum culture, serum ESR, CRP and PCT levels were lower than those of single detection, and the differences were significant (P<0.05). Conclusions The serum levels of ESR, CRP and PCT are higher in patients with lower respiratory tract infection, and the detection of serum ESR, CRP and PCT is helpful to identify the types of infection. Sputum culture combined with serum ESR, CRP and PCT levels in the diagnosis of lower respiratory tract infection can significantly improve the sensitivity, specificity and accuracy of the diagnosis, and the application value is higher. Key words: Sputum culture; Erythrocyte sedimentation rate; C reactive protein; Procalcitonin; Lower respiratory tract infection

BackgroundThe purpose of this study was to explore the diagnostic value of soluble triggering receptor expressed on myeloid cells 1 (sTREM-1), procalcitonin (PCT), and C-reactive protein (CRP) serum levels for differentiating sepsis from SIRS, identifying new fever caused by bacteremia, and assessing prognosis when new fever occurred.MethodsWe enrolled 144 intensive care unit (ICU) patients: 60 with systemic inflammatory response syndrome (SIRS) and 84 with sepsis complicated by new fever at more than 48 h after ICU admission. Serum sTREM-1, PCT, and CRP levels were measured on the day of admission and at the occurrence of new fever (>38.3°C) during hospitalization. Based on the blood culture results, the patients were divided into a blood culture-positive bacteremia group (33 patients) and blood culture-negative group (51 patients). Based on 28-day survival, all patients, both blood culture-positive and -negative, were further divided into survivor and nonsurvivor groups.ResultsOn ICU day 1, the sepsis group had higher serum sTREM-1, PCT, and CRP levels compared with the SIRS group (P <0.05). The areas under the curve (AUC) for these indicators were 0.868 (95% CI, 0.798–0.938), 0.729 (95% CI, 0.637–0.821), and 0.679 (95% CI, 0.578–0.771), respectively. With 108.9 pg/ml as the cut-off point for serum sTREM-1, sensitivity was 0.83 and specificity was 0.81. There was no statistically significant difference in serum sTREM-1 or PCT levels between the blood culture-positive and -negative bacteremia groups with ICU-acquired new fever. However, the nonsurvivors in the blood culture-positive bacteremia group had higher levels of serum sTREM-1 and PCT (P <0.05), with a prognostic AUC for serum sTREM-1 of 0.868 (95% CI, 0.740–0.997).ConclusionsSerum sTREM-1, PCT, and CRP levels each have a role in the early diagnosis of sepsis. Serum sTREM-1, with the highest sensitivity and specificity of all indicators studied, is especially notable. sTREM-1, PCT, and CRP levels are of no use in determining new fever caused by bacteremia in ICU patients, but sTREM-1 levels reflect the prognosis of bacteremia.Trial registrationClinicalTrial.gov identifier NCT01410578

BackgroundBoth C reactive protein (CRP) and procalcitonin (PCT) are well known acute phase reactant proteins. CRP was reported to increase in metabolic syndrome and type-2 diabetes. Similarly altered level of serum PCT was found in chronic liver diseases and cirrhosis. The liver is considered the main source of CRP and a source of PCT, however, the serum PCT and CRP levels in non-alcoholic fatty liver disease (NAFLD) were not compared previously. Therefore we aimed to study the diagnostic and discriminative role of serum PCT and CRP in NAFLD.MethodsFifty NAFLD cases and 50 healthy controls were included to the study. Liver function tests were measured, body mass index was calculated, and insulin resistance was determined by using a homeostasis model assessment (HOMA-IR). Ultrasound evaluation was performed for each subject. Serum CRP was measured with nephalometric method. Serum PCT was measured with Kryptor based system.ResultsSerum PCT levels were similar in steatohepatitis (n 20) and simple steatosis (n 27) patients, and were not different than the control group (0.06 ± 0.01, 0.04 ± 0.01 versus 0.06 ± 0.01 ng/ml respectively). Serum CRP levels were significantly higher in simple steatosis, and steatohepatitis groups compared to healthy controls (7.5 ± 1.6 and 5.2 ± 2.5 versus 2.9 ± 0.5 mg/dl respectively p < 0.01). CRP could not differentiate steatohepatitis from simple steatosis. Beside, three patients with focal fatty liver disease had normal serum CRP levels.ConclusionSerum PCT was within normal ranges in patients with simple steatosis or steatohepatitis and has no diagnostic value. Serum CRP level was increased in NAFLD compared to controls. CRP can be used as an additional marker for diagnosis of NAFLD but it has no value in discrimination of steatohepatitis from simple steatosis.

Objective To explore the diagnosis significance of serum procalcitonin (PCT) and C-reactive protein(CRP) in the fever of hematological maliganancies. Methods The levels of serum PCT and CRP in 186 fever patients with hematological maliganancies and 30 non-fever patients with hematological maliganancies were analyzed retrospectively. According to the clinical characteristics, the patients were divided into infectious fever patients (165 cases), non-infectious fever patients (21 cases) and non-fever patients (30 cases). The infectious fever patients were divided into the bacterial infection (102 cases), the fungal infection (27 cases), and the virus infection (36 cases). The patients confirmed with bacteria infection were divided into blood culture positive patients (24 cases, including 12 cases of gram-negative bacteria infection and 12 cases of gram-positive bacteria infection) and blood culture negative patients (78 cases) according to the result of blood culture. The levels of serum PCT and CRP were compared. Results The levels of serum PCT and CRP in infectious fever patients were higher than those in non-infectious fever patients and non-fever patients:1.40(0.02-54.81) μg/L vs. 0.45(0.04-12.80) μg/L and 0.30(0.01-0.98) μg/L, 78.9(3.6-199.6) mg/L vs. 17.1(2.4-78.9) mg/L and 6.7(1.0-24.2) mg/L,and there were significant differences (P 0.05). The level of serum PCT in bacterial infection was higher than that in fungal infection and virus infection:1.60 (0.28-54.81) μg/L vs. 0.55 (0.17-9.60) μg/L and 0.38 (0.02-12.45) μg/L, and there was significant difference (P 0.05). There was no significant difference in the level of serum CRP among bacterial infection, fungal infection and virus infection (P >0.05). The level of serum PCT and the positive rate of PCT in blood culture positive patients were higher than those in blood culture negative patients: 2.10 (0.35-54.81) μg/L vs. 0.78(0.28-22.41) μg/L, 87.5% (21/24) vs. 66.7% (52/78), there were significant differences (P 0.05). There were no significant differences in the level of serum CRP and the positive rate of CRP between blood culture positive patients and blood culture negative patients, or between gram-negative bacteria infection and gram-positive bacteria infection (P >0.05). Conclusions Serum PCT concentration can help to distinguish the infectious fever and non-infectious fever, especially to gram-negative bacteria infection. Serum CRP concentration is significant in distinguishing the infectious fever and non-infectious fever. Key words: Hematologic neoplasms; Fever; C-reactive protein; Procalcitonin

Objective Based on the 2012 Atlanta classification criteria, to study the value of C-reactive protein (CRP) and procalcitonin (PCT) in the early forecasting acute pancreatitis (AP). Methods Eighty-three patients with AP were selected. The patients were divided into mild AP (MAP) group (39 cases), moderately severe AP (MSAP) group (31 cases) and severe AP (SAP) group (13 cases) according to the 2012 Atlanta classification criteria. Twenty-seven healthy people were selected as control group. The levels of serum CRP and PCT were measured. The predictive value of serum CRP and PCT levels for SAP, infectious pancreatic necrosis (IPN), organ failure and death risk was assessed using the area under the curve (AUC). Results The serum CRP and PCT levels in MAP group, MSAP group and SAP group were significantly higher than those in control group: (49.84 ± 12.26), (89.77 ± 22.10) and (123.69 ± 37.09) mg/L vs. (3.92 ± 1.37) mg/L, (1.15 ± 0.42), (2.44 ± 0.61) and (3.27 ± 0.96) μg/L vs. (0.41 ± 0.13) μg/L, and those in MSAP group and SAP group were significantly higher than those in MAP group, those in SAP group were significantly higher than those in MSAP group, and there were statistical differences (P<0.05). The Spearman correlation analysis result showed that AP severity was positively correlated with serum CRP and PCT levels (r= 0.652 and 0.714, P<0.05). The accuracy of serum CRP level for forecasting SAP and IPN was medium (AUC= 0.73 and 0.76), and for forecasting organ failure accuracy was low (AUC= 0.67). Serum CRP showed no significance in forecasting death risk (AUC= 0.46). The accuracy of serum PCT level for forecasting SAP, IPN and death risk accuracy was medium (AUC= 0.71, 0.86 and 0.80), and for forecasting organ failure accuracy was low (AUC= 0.64). Conclusions Based on the 2012 Atlanta classification criteria, the accuracy of serum CRP level for forecasting SAP is higher than that of serum PCT level, the accuracy of serum PCT level for forecasting IPN and death risk is higher than that of serum CRP level, and accuracy of serum CRP and PCT levels for forecasting organ failure are low. Key words: Pancreatitis; C-reactive protein; Calcitonin; Retrospective studies

Objective To detect the clinical value of the levels of serum procalcitonin (PCT) and C-reactive protein(CRP)in children with febrile disease. Methods From October 2009 to October 2010, clinical data of 174 children suffered from febrile disease were recruited. According to their discharge diagnosis, they were divided into bacteria infect disease group(n=79), non-bacteria infect disease group (n=71) and rheumatic disease group(n=26). Meanwhile, another 40 cases of healthy children were recruited into control group(n=35). PCT and CRP levels were detected in all cases including thirty-five healthy control cases. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Fujian Provincial Hospital of Fujian Medical University. Informed consent was obtained from the parents of each participating child. There had no significance difference between four groups among gender, age, and complicating other diseases (P>0.05). Retrospective analytical method were conducted on the levels of CRP and PCT among four groups. Results The levels of CRP in bacteria infection disease group, non-bacteria infection disease group, rheumatic disease group and control group were (24.34±4.21) mg/L, (1.32±0.04) mg/L, (101.31±15.20) mg/L and (1.29± 0.03) mg/L, respectively. And the levels of PCT were (4.17±0.92)μg/L, (0.06±0.01)μg/L, (0.70±0.11)μg/L and (0.08±0.02)μg/L, respectively. Levels of PCT and CRP were dramatically higher in bacteria infection diseases group (P<0.01). And there were no significant difference in the levels of PCT and CRP between non-bacteria infection diseases group and control group. In rheumatic disease group, the level of CRP was much higher than that in control group (P<0.001), and the level of PCT increased a little with no significant difference compared with that in control group (P<0.05). Conclusion The measurement for the levels of serum CRP and PCT might be a valuable indicator in the diagnosis of febrile disease in children. Key words: procalcitonin; C-reactive protein; febrile disease; child

Background: The aim of the study was to evaluate the effect of the systemic inflammatory response syndrome (SIRS) on serum high-molecular-weight adiponectin (HMWA) levels. Method: Twelve children with SIRS were enrolled in this study at the intensive care unit (ICU). Twelve age and sex matched healthy subjects were selected as controls. Serum HMWA, interleukin-6 (IL-6), C-reactive protein (CRP), and procalcitonin (PCT) levels were determined after 2 hours and 24 hours, and on the day of discharge which was on the average 9.4 days after ICU admission. Results: 2 hours after admission to the ICU, the patients had significantly decreased serum HMWA levels compared with healthy controls (P &lt; .001). 24 hours after the admission, the patients did not have any significant changes in their HMWA levels, however on the day of discharge, on average 9.4 days after hospital admission, a significant increase was observed (P &lt; .05). After the treatment, there was a decrease in serum PCT, IL-6 and CRP levels. The only variable that was decreased 24 hours after the ICU admission was PCT (P &lt; .05). A negative correlation was found between serum HMWA and PCT levels, and between HMWA and CRP (P &lt; .05 and P &lt; .01), however no correlation was found between HMWA and IL-6. Conclusion: In SIRS we observed a marked reduction in serum HMWA concentrations and a profound increase in IL-6, PCT, and CRP levels. A significant relationship between serum HMWA and PCR and CRP levels was evident.

Henoch-Schönlein purpura (HSP) is a vasculitic disorder resulting from autoinflammatory-mediated tissue injury. Procalcitonin (PCT) and C-reactive protein (CRP) are two biomarkers of the immune response that recognize bacterial infection and inflammation, respectively. This study tested whether levels of PCT and CRP were associated with selected clinical features, disease severity, and organ damage in HSP. Eighty-nine pediatric patients with HSP were analyzed for clinical manifestations and organ damage. Serum CRP, PCT, and occult blood in the urine and stool (prior to steroid therapy) were measured. Disease severity was classified according to previously established clinical classifications. Sixty patients (67.4 %) had a low clinical score (LCS) of <4 (group A) while 29 patients (32.5 %) had a high clinical score (HCS) of ≥4 (group B). When patients were then classified by the presence of gastrointestinal bleeding, 66 (74.2 %) cases lacked alimentary tract hemorrhage (group C) while 23 (25.8 %) cases presented with gastrointestinal bleeding (group D). There were no significant differences in CRP (group A: median = 5.26, range = 1.00-77.60 vs. group B: median = 8.59, range = 1.00-144.00 mg/l; u = 1.397) or PCT levels (group A: median = 0.05, range = 0.05-0.24 vs. group B: median = 0.08, range = 0.05-1.02 ng/ml; u = 1.709) between groups A and B. When serum PCT levels were examined in relation to gastrointestinal bleeding, the levels of serum PCT were higher in group D than group C patients (group D: median = 0.09, range = 0.05-1.02 vs. group C: median = 0.05, range = 0.05-0.32 ng/ml; u = 2.849). It is important to note that the average PCT level was below the threshold for a systemic bacterial infection (0.5 ng/ml). We did not observe a correlation between CRP levels and the absence or presence of GI bleeding in groups C or D (group C: median = 4.66, range = 1.00-144.00 vs. group D: median = 9.44, range = 1.06-124.00 mg/l; u = 1.783), respectively. In all patients, there was a significant correlation between the concentrations of PCT and CRP (r = 0.721, p = 0.002). In patients with HSP, inflammatory markers are not uniformly associated with the disease and instead, show variable association depending on the clinical severity and level of organ damage. In patients with severe HSP, elevated serum PCT was significantly associated with gastrointestinal bleeding. In contrast, CRP was not a specific predictor for different clinical classifications of HSP, despite a similar pattern of concentration changes to PCT.

Procalcitonin and C-reactive protein in WHO defined severe and very severe community acquired pneumonia: A hospital based cross-sectional study

To investigate the association of procalcitonin (PCT) with ulcerative colitis (UC) activity. Serum PCT levels, C-reactive protein (CRP) levels, the erythrocyte sedimentation rate, and the white blood cell count were analyzed in 18 patients with UC and 11 healthy volunteers. Serum PCT levels were analyzed by an electrochemiluminescence immunoassay. Severity assessments were based on Truelove and Witts' severity index. Correlation of serum PCT and CRP levels with UC activity was examined. Moreover, we assessed serum PCT and CRP levels in patients with a Mayo endoscopic subscore. Serum PCT levels in severe UC patients (n = 7) (0.096 ± 0.034 ng/mL) were significantly higher than in mild-to-moderate UC patients (n = 11) (0.033 ± 0.012 ng/mL) and healthy volunteers (n = 11) (0.035 ± 0.005 ng/mL) (P = 0.0005 and P < 0.0001, respectively). In addition, there was no difference in serum PCT levels between mild-to-moderate UC patients and healthy volunteers. Interestingly, patients with a Mayo endoscopic subscore of 3 points displayed significantly increased levels of serum PCT (0.075 ± 0.043 ng/mL) compared with patients with a subscore of 2 points (0.03 ± 0.011 ng/mL) (P = 0.0302). Moreover, CRP levels in patients with severe UC or a Mayo endoscopic subscore of 3 points were not significantly higher than in patients with mild-to-moderate UC or a Mayo endoscopic subscore of 3 points. Serum PCT levels were significantly correlated with UC activity.

The aim of this study was to explore the clinical value of serum procalcitonin (PCT) and C-reactive protein (CRP) levels in evaluating complications after endoscopic retrograde cholangiopancreatography (ERCP) in patients with common bile duct (CBD) stones. Patients who were diagnosed with CBD stones and underwent ERCP from December 2021 to December 2023 were selected as the study subjects. According to whether postoperative complications occurred, they were divided into complication group (n = 28) and non-complication group (n = 132). The general clinical data, biochemical indexes, serum PCT, and CRP levels before ERCP and 4 hours and 24 hours after ERCP were compared. The changes of serum PCT and CRP levels in patients with different types of complications at 4 hours and 24 hours after ERCP were analyzed. The value of serum PCT, CRP levels, and combined indicators in distinguishing postoperative complications was analyzed. The proportion of previous pancreatitis and complications (hypertension and diabetes) in the complication group was higher than that in the non-complication group. Serum PCT and CRP levels of patients in the complication group were significantly higher than those in the non-complication group at 24 hours after ERCP (p < 0.001). Stratified according to the main types of complications, CRP level of patients with postoperative pancreatitis continued to increase at 4 hours and 24 hours after ERCP, while serum PCT increased only after 24 hours. When serum PCT and CRP levels were higher than 2.61 μg/mL and 68.18 mg/mL, respectively, at 24 hours after ERCP, the patients with postoperative complications could be well distinguished. The combination of the two indicators had a higher value in distinguishing patients with postoperative complications than the serum indicators alone. The increase of serum PCT and CRP levels after ERCP is related to the complications after ERCP in patients with CBD stones. For patients with a high risk of complications after ERCP, the possibility of complications occurring can be evaluated by combined examination of serum PCT and CRP levels, and prevention and treatment measures can be taken as soon as possible.

To investigate the role of the triple combination serum heparin-binding protein (HBP), procalcitonin (PCT), and C-reactive protein (CRP) in children with acute bacterial upper respiratory tract infection (ABURTI). A total of 130 children with upper respiratory tract infection admitted to the Department of Pediatrics of Fujian Maternity and Child Health Hospital from September 2019 to January 2021 were selected as the research group. According to the results of pathogenic analysis, children were further subdivided into a bacterial infection group (n = 67) and a viral infection group (n = 63). Additionally, 65 children who underwent physical examinations in our hospital during the same period were collected and included into the control group (n = 65). All patients selected were treated with cefixime granules orally for 5 days. Serum HBP level, serum PCT level, and serum CRP level were measured by double antibody Sandwich Enzyme Linked Immunosorbent Assay (ELISA), fluorescence method, and immunoturbidimetric assay, respectively. The expression levels of the three indicators in the serum of all subjects were compared, and the receiver operating characteristic (ROC) curve was used to analyze their diagnostic value in children with ABURTI. Furthermore, according to clinical efficacy of children with bacterial infections, they were divided into a good efficacy group (markedly effective) and a poor efficacy group (effective + ineffective) to compare serum HBP, PCT, and CRP levels between the two groups. The ROC curve was drawn to analyze the value of the three indicators in predicting the curative effect in children with ABURTI. Pearson test was used to analyze the correlation among the expression of HBP, PCT, and CRP. Results showed that the expression levels of HBP, PCT, and CRP in the serum of children in the bacterial infection group were significantly higher than those in the other two groups. The positive rates of HBP, PCT, and CRP in children in the bacterial infection group were also significantly higher than those of the other two groups. The area under the curve (AUC) of the combined diagnosis of HBP, PCT, and CRP was 0.973, which was significantly higher than that of the single detection by any of the three indicators, which were 0.849, 0.819, and 0.854, respectively. The expression levels of HBP, PCT, and CRP in the serum of children in the good efficacy group were significantly lower than those in the poor efficacy group, and the AUC of the triple combination for predicting treatment efficacy was 0.959. Pearson test showed that there was a positive correlation between the serum expression of HBP, PCT, and CRP in children. HBP, PCT, and CRP were highly correlated in children with ABURTI, and their combined detection was of high diagnostic value among ABURTI patients, indicating that the three were expected to become potential indicators for efficacy prediction.