Clinical significance of procalcitonin and leukocyte count in diagnosis of complicated pulmonary infection in patients with maintenance hemodialysis

Objective To investigate the clinical value of procalcitonin (PCT) and white blood cell count (WBC) in diagnosis of complicated pulmonary infection in patients with maintenance hemodialysis.Methods A total of 87 patients were selected as the infection group,who underwent maintenance hemodialysis (MHD) in Blood Purification Centre,Affiliated Hospital of North Sichuan Medical College from June 2017 to December 2018,and complied with diagnosis criteria of pulmonary infection in clinical examinations,imaging examinations and laboratory tests.A total of 75 MHD patients without pulmonary infection or other site infection in the same period were selected as the non-infection group.General data and clinical examination data of all the above patients were collected,including age,sex,body mass index,primary disease,blood routine,blood biochemistry,parathyroid hormone,C-reactive protein (CRP),PCT and so on.Retrospective analysis was done on the data after enrollment.Results (1) Compared with the non-infection group,the levels of albumin and total cholesterol in the infection group were significantly lower,while the levels of WBC,neutrophil percentage,PCT and CRP were significantly higher (P<0.05).(2) Multivariate Logistic regression analysis showed that PCT (OR=70.625,95%CI 13.783~361.891,P<0.05) and WBC (OR=1.435,95%CI 1.133~1.817,P<0.05) were independent risk factors for pulmonary infection in MHD patients.(3) The areas under the receiver operating characteristic curve of PCT,WBC and PCT+WBC for the combined diagnosis of maintenance hemodialysis patients with pulmonary infection were 0.880(0.828~0.932),0.717(0.638~0.797) and 0.905(0.859~0.951)(P<0.05),respectively.Conclusions PCT and WBC are independent risk factors of pulmonary infection in MHD patients.The combined detection of PCT and WBC is more effective in the diagnosis of pulmonary infection in MHD patients.