Application Value Of Serum Heparin Binding Protein In Early Diagnosis Of Sepsis In Children

Object To study the significance of heparin binding protein(HBP)、 procalcitonin(PCT)and C-reactive protein(CRP)in early diagnosis of sepsis.Methods The data of children hospitalized and diagnosed as sepsis in our hospital from January 2019 to February 2020 were reviewed.According to the severity of sepsis,they were divided into sepsis group(n=35),severe sepsis group(n=16)and septic shock group(n=10).In the same period,30 children hospitalized due to local infection were divided into local infection group.Kruskal-Wallis H test was used to compare the expression levels of serum HBP,PCT and CRP in each group,and the receiver working characteristic curve(ROC curve)was used to compare the diagnostic efficacy of each index in early diagnosis of sepsis.Results(1)The serum HBP levels in local infection group,sepsis group,severe sepsis group and septic shock group were [19.53(8.24,26.26)、30.78(24.93,43.88)、53.67(47.73,64.51)、174.87(141.57,245.30)μg/L],and there were significant differences among the four groups(H=58.162,P<0.05).Further comparison between groups showed that there were significant differences in pairwise comparison among the four groups(all P<0.008),and its expression level increased with the severity of the disease.(2)The serum PCT levels in local infection group,sepsis group,severe sepsis group and septic shock group were [1.19(0.43,1.57)、2.00(1.50,5.00)、10.00(5.30,15.75)、18.80(17.65,19.00)ng/ml],and there were significant differences among the four groups(H=45.163,P<0.05).Further comparison between groups showed that there were significant differences in pairwise comparison among the four groups(all P<0.008),and its expression level increased with the severity of the disease.(3)The serum CRP levels in local infection group,sepsis group,severe sepsis group and septic shock group were [49.14(34.20,61.28)、 54.70(44.40,69.99)、63.66(54.74,65.16)、78.85(66.40,86.87)mg/L],and there were significant differences among the four groups(H=45.163,P<0.05).Pairwise comparison showed that there was significant difference between local infection group,severe sepsis group and septic shock group(all P<0.008).There was significant difference in serum CRP level between sepsis group and septic shock group(P<0.008),but there was no significant difference among other groups.(4)ROC curve analysis showed that when diagnosing sepsis,the AUC(area under the curve)of serum HBP,PCT and CRP were 0.878,0.841 and 0.740 respectively,and the AUC of the three combined tests were 0.909 and 0.922,respectively.The combined detection of the three indexes had the best specificity in the diagnosis of sepsis,and the combined detection of HBP+PCT had the best sensitivity in the diagnosis of sepsis.(5)In children with sepsis,there was a pairwise positive correlation among CRP,PCT and HBP,and the correlation coefficient between HBP and PCT was 0.589(P<0.05).The correlation coefficient between HBP and CRP was 0.380(P<0.05).The correlation coefficient between PCT and CRP was 0.453(P<0.05).Through further comparison,it is found that the absolute value of the correlation coefficient between HBP and PCT is closer to 1.Conclusions(1)The levels of serum HBP,PCT and CRP have certain value in the diagnosis of sepsis in children,and there is a positive correlation among them.(2)The levels of serum HBP and PCT increase with the aggravation of the disease,which has a certain clinical significance for the grading diagnosis of sepsis.(3)The combined detection of HBP,PCT and HBP has good diagnostic value for the diagnosis of sepsis,and further improves the sensitivity and specificity of detection,which can reduce the missed diagnosis rate and misdiagnosis rate of sepsis in children.