The Predictive Value of Dynamic Changes in Procalcitonin and C-Reactive Protein in Evaluating Response of Patients with Pulmonary Tuberculosis in the Early Treatment

Objective: To explore the predictive value of dynamic changes in procalcitonin (PCT) and C-reactive protein (CRP) in evaluating early treatment response in patients with pulmonary tuberculosis (PTB). Methods: A retrospective study was conducted on 168 PTB patients from June 2022 to June 2024. Based on early treatment efficacy, patients were divided into an effective group (136 cases, 80.95%) and an ineffective group (32 cases, 19.05%). Clinical data of the two groups were compared, and variables showing significant differences were analyzed using logistic regression analysis. The predictive value was evaluated through ROC curves, nomograms, and calibration curves. The dynamic changes in PCT and CRP and their correlations with treatment outcomes were also analyzed. Results: Significant differences were observed between the ineffective and effective groups in terms of the number of lung fields involved and pulmonary cavitary lesions (P < 0.05). Additionally, baseline levels of PCT, CRP and IL-6 were significantly higher in the ineffective group than in the effective group (P < 0.05). The number of lung fields involved, pulmonary cavitary lesions, PCT, CRP, and IL-6 were identified as independent factors influencing early treatment efficacy in PTB patients. PCT, CRP, and IL-6 demonstrated high predictive value for treatment outcomes. On days 1, 5, and 7 after treatment, PCT and CRP levels were significantly lower in the effective group than in the ineffective group (P < 0.05), with the most pronounced difference observed on day 1. Greater reductions in PCT and CRP levels were associated with better treatment outcomes and larger lesion absorption area (P < 0.05). Conclusion: The number of lung fields involved, pulmonary cavitary lesions, PCT, CRP, and IL-6 all influence early treatment efficacy in PTB patients. Among these, dynamic changes in PCT and CRP exhibit high predictive value, providing a reliable basis for clinical assessment. Keywords: pulmonary tuberculosis, procalcitonin, C-reactive protein, interleukin-6, pulmonary cavitary lesions