The Research And Analysis Of Procalci Tonin And C-reactive Protein Detection In The Early Diagnosis Of Sepsis Patients And Assessment Of Disease Condition

Objective: To study the serum procalcitonin and C-reactive protein detection so as to provide favorable guidance based on the clinical early and accurate diagnosis,effective and reasonable treatment,and a good prognosis in patients with sepsis.Methods: For the assessment,302 patients hospitalized from January 1st 2013 to December 31 2015 were selected from the ICU of Jiangsu university hospital,and in accordance with sepsis criteria for the diagnosis of 302 patients were divided into three groups(sepsis group,septic shock group and control group).The sepsis group consisted of 102 patients(56 male patients + 46 female patients),aged 39-68 years old.The septic shock group consisted of 87 patients(47 male patients + 40 female patients),aged 42-75 years old.The control group consisted of 113 patients(50 male patients + 63 female patients),aged 40-74 years old.For all the patients,serum PCT and CRP were measured through ELFA(enzyme linked fluorescence analysis)and QICC(quantitative immunocytochemistry),respectively.The final measurements were compared among the groups to make clear the differences,and ROCs(receiver operating characteristic curves)were drawn against the PCT and CRP levels to learn the sensitivity,specificity,accuracy,PPV(positive predictive value)and NPV(negative predictive value)of diagnosing sepsis with the inflammatory indexes,through comparison.Indicated by the analysis with professional statistical software,the final data were of statistical significance(P<0.05).Results:1.No significant difference(P>0.05)was found among the sepsis,septic shock and control groups in age,gender,APACHE II score or LOS(length of stay(days))in ICU.However,a significant difference(P<0.05)was found in ISS(injury severity score)and I-HMR(in-hospital mortality rate).2.The serum PCT of the sepsis group was(6.03±3.98 ug/L),higher than that of the control group(1.68±0.93 ug/L)but lower than that of the septic shock group(14.03±9.61 ug/L).The differences were of significance(P<0.05).The CRP of the sepsis group was(34.91±15.71 mg/L),higher than that of the control group (12.41±7.98 mg/L)but lower than that of the septic shock group(148.29±32.04 mg/L).The differences were of significance(P<0.05).3.The measured PCT positive rates of the septic shock,sepsis and control groups were93.1%、80.4%and 29.2%,respectively.The differences among the three groups in this index were also of significance(X2=104.335;P<0.05).The measured CRP positive rates of the septic shock,sepsis and control groups were 90.8%、79.4% and25.7%,respectively.The differences among the three groups in this index were also of significance(X2=107.702;P<0.05).4.The sensitivity,specificity,accuracy,PPV and NPV of diagnosing sepsis by measuring both PCT and CRP(84.7%、87.6%、92.0%、77.3%、85.8%)were higher than those of diagnosing sepsis by only measuring PCT(75.7%、77.0%、84.7%、65.4%、76.2%)or CRP(77.8%、74.3%、83.5%、66.7%、76.5%).The differences were of significance(P<0.05).The ROC of measuring both PCT and CRP had an AUC(area under curve)of 0.922(95% confidence interval:(0.872,0.971).The ROC of only measuring PCT had an AUC(area under curve)of 0.850(95% confidence interval:(0.777,0.923).The ROC of only measuring CRP had an AUC(area under curve)of 0.814(95% confidence interval:(0.730,0.898).Conclusions:1.The severity of a sepsis patient can be assessed by measuring serum PCT and CRP.Higher serum PCT and CRP levels mean higher severity.2.The sensitivity and specificity of measuring both PCT and CRP are much higher than those of only measuring PCT or CRP.Such measurement performs much more reliably in diagnosis of sepsis.