THE VALUE OF PROCALCITONIN IN THE DIAGNOSIS OF PNEUMONIA IN MILITARY PERSONNEL

Shirinova F. V.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

In clinical practice, the procalcitonin test (PCT) is used to diagnose sepsis and monitor the effectiveness of antibacterial therapy in community-acquired pneumonia (CAP). The arrival of military personnel to a new place of service leads to adaptive stress of the body’s defense systems, in particular, under the influence of all the above factors, dysadaptation disorders develop, among which CAP is most often observed. Goal. To determine the diagnostic significance of procalcitonin as a new biological marker of infection in dysadaptation disorders of the body’s defense system that occurs in pneumonia in military personnel. Methods. The material of the study was clinical and anamnestic data of 266 military personnel with pneumonia. From laboratory methods, the study of the marker of infection – procalcitonin (PCT), inflammatory markers of violations of the protective system – V. CH.CRP and determination by the routine method – ESR was carried out. Results. It was found that servicemen with pneumonia had such complaints as cough, high temperature, chest pain, shortness of breath, malaise, General weakness 2-3 days before admission to the hospital. Along with physical examination, chest fluorography and ECG examination were performed to verify lobular or bilateral pneumonia. To clarify the diagnostic informativeness of PCT, its level was studied in 44 servicemen with pneumonia before admission to the hospital and in 44 – after treatment. It was found that lung damage in 22 (50%) was detected in the right lobe, in 13 (29.5%) – in the left lobe and in 9 (20.5%) – bilateral lung damage was noted. Serum PCT levels were determined before treatment and 4 days after treatment. The therapy included-compliance with the regime, diet, the use of Ceftriaxone, ciprofloxacin, oflaxocin, Bromhexine, fluconazole, diclofenac, amoxicycline and vitamin therapy. Before the start of therapy, the PCT level was 0.5±0.09 ng/ml, and on the 4th day after the start of treatment, decreasing by 6.3 times, fell to values of 0.08±0.01 ng/ml (p<0.05). Thus, the data obtained in the determination of PCT can prevent the transformation of infection into sepsis, which confirms its diagnostic information, and, at the same time, demonstrates the effectiveness of antibiotic therapy. If you suspect a trip, it is necessary, as defendants, the body’s defense system, determination a routine technique such markers of inflammation as V. h. CRP and ESR. The study found that the level of ESR at the beginning of treatment was 18.3±1.04 mmHg and after treatment 12.7±1.09 mm Hg.art., (normally m: 1-10 mm/h; W: 2-15 mm/h). Conclusion. For the diagnosis of VP, along with detailed anamnesis, it is advisable to determine the serum infectious marker PCT, as well as biological markers of inflammation V. CH.CRP and ESR. Based on the dynamics of the recommended tests, it is also necessary to correct the duration of antibacterial therapy

military personnel, pneumonia, diagnosis, procalcitonin.

1. Bogomolov AB. Osobennosti techenija vnebol’nichnoj pnevmonii u voennosluzhashhih v sovremennyh uslovijah v zavisimosti ot struktury kontingentov i klimatogeograficheskih aspektov [dissertatsiya]. Sankt-Peterburg: 2010. 169 s. [in Russian].
2. Mediko-demograficheskie pokazateli Rossijskoj Federacii v 2010 godu. Statisticheskie materialy. FGBU “CNIIOIZ” Minzdravsocrazvitija Rossii. M.: 2011. 164 s. [in Russian].
3. Mirovaja statistika zdravoohranenija 2010 goda. VOZ, 2010. 177 s. [in Russian].
4. Morrison VV, Bozhedomov AJu. Znachenie opredelenija koncentracii prokal’citonina plazmy krovi v diagnostike septicheskih sostojanij. Sarat. nauch.-med. zhur. 2010;6(2):261-7. [in Russian].
5. American Thoracic Society. Trends in pneumonia and influenza morbidity and mortality 2010.
6. Bochud PY, Moser F, Erard P, Verdon F, Studer JP, Villard G, et al. Community-acquired pneumonia. A prospective outpatient study. Medicine (Baltimore). 2001 Mar;80(2):75-87.
7. Gibson GJ, Loddenkemper R, Sibille Y, Belgium Y, Lundbäck B, Fletcher M. Lung health in Europe – facts and figures. European Lung Foundation. 2013. 71 p.
8. Bartlett J. Respiratory Tract Infections. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2001. 154 p.
9. Niu Wy, Wan Yg, Li My, Wu Zx, Zhang Lg, Wang Jx. The diagnostic value of serum procalcitonin, IL- 10 and C- reactive protein in community acquired pneumonia and tuberculosis. Eur. Rev. Med. Pharmacol. Sci. 2013;17(24):3329-33.
10. Ponikarovskaja LA, Logvinenko NI. Ambulatornye pnevmonii. Bjulleten’. 2004;18:48-51. [in Russian].
11. Adam TH, Uil’jam AHU, Hav’er Je. Atlas respiratornyh infekcij (perevod s anglijskogo pod red. prof. S.I. Ovcharenko). M.: izd-vo «GJeOTARMedia»; 2011. 184 s. [in Russian].
12. Chuchalin AG. Biologicheskie markery pri respiratornyh zabolevanijah. Terapevt. arhiv. 2014;3:4-13. [in Russian].
13. Schuetz P, Christ-Crain M, Thomann R, Falconnier C, Wolbers M, Widmer I, et al. Effect of procalcitonin-based guidelines vs standard guidelines on antibiotic use in lower respiratory tract infections: the ProHOSP randomized controlled trial. JAMA. 2009;302(10):1059-66.

«Bulletin of problems biology and medicine» Issue 4 Part 2 (154), 2019 year, 255-258 pages, index UDK 616.24-07

10.29254/2077-4214-2019-4-2-154-255-258