Study On The Value Of Combined Detection Of Serum MR-proADM,PCT And CRP In Evaluating Sepsis Patients’ Condition And Prognosis

Objective:To investigate the clinical value of mid-regional pro-adrenomedullin(MR-proADM),C-reactive protein(CRP)and procalcitonin(PCT)of patients with sepsis in assessing the severity of disease and predicting prognosis.Methods:Patients with sepsis admitted to the ICU of The First Affiliated Hospital of Nanchang University from June 2018 to December 2019 were selected as the research subjects,and their MR-proADM,PCT and CRP levels were measured 6 to 8 hours after the diagnosis.The patient’s APACHE Ⅱ score and SOFA score were calculated,and the survival outcome of the patient after 28 days of admission was followed up and recorded.According to the severity of the patients,they were divided into sepsis group and septic shock group.Another 40 healthy subjects were selected as the control group.The differences in the expression levels of MR-proADM,PCT and CRP among the three groups were compared.According to the survival status of sepsis patients at 28-day,the patients were divided into survival group and death group.The differences in levels of MR-proADM,PCT and CRP expression were compared between the two groups,a receiver operating curve(ROC)was drawn to evaluate the value of MR-proADM,PCT,and CRP alone and in combination in the diagosis of sepsis,the assessment of severity,and the perdiction of prognosis.Results:A total of 106 patients were included in the study,including 62 patients with sepsis,44 patients with septic shock,and 39 deaths.The MR-proADM,PCT,and CRP levels of patients in septic shock group were significantly higher than those in sepsis group.The patients in the sepsis group were significantly higher than those in the healthy control group,and the differences were statistically significant(P <0.01).The AUC of MR-proADM in the diagnosis of sepsis was 0.911,the sensitivity was90.5%,and the specificity was 79.7%,which were higher than PCT and CRP.The AUC of MR-proADM to assess the severity of sepsis was 0.863,the sensitivity was79.5%,and the specificity was 67.1%,which were higher than PCT and CRP.The AUC of the three indicators to assess the severity of sepsis was 0.920 and the sensitivity was 86.4%,and the specificity was 90.5%,which were higher than the single indicator.The levels of MR-proADM,PCT and CRP in the death group were significantly higher than those in the survival group,and the differences were statistically significant(P <0.01).MR-proADM predicts the death of sepsis patients with AUC of 0.810,sensitivity of 76.9%,specificity of 82.1%,which were significantly higher than PCT and CRP.The three indicators combined to predict the death of sepsis patients have an AUC of 0.904,which was sensitive.The sensitivity was 84.6%,and the specificity was 86.6%,which were higher than a single indicator.The expression level of MR-proADM and the expression level of CRP and PCT of patients in the survival and death groups were significantly correlated(P <0.05).Conclusions:1.The levels of MR-proADM,PCT and CRP in patients with septic shock were higher than those in patients with sepsis.The patients in the sepsis group were significantly higher than those in the healthy population.ROC curve showed that the AUC,sensitivity and specificity of MR-proADM in the diagnosis of sepsis were higher than those of PCT and CRP.2.MR-proADM,PCT and CRP combined to evaluate the AUC,sensitivity,specificity of sepsis were higher than any of the individual indicators.3.The MR-proADM,PCT and CRP levels of patients who died 28 days after admission were higher than those of surviving patients.The AUC,sensitivity,and specificity of the three indicators combined to predict death in patients with sepsis are higher than any one of the individual indicators.MR-proADM was positively correlated with PCT and CRP.