Clinical Study On Diagnostic Value Of Serum Procalcitonin Inpatients With Sepsis

Objectives:By measuring and comparatively studying the levels of the serum procalcitonin(PCT),C-reactive protein(hsCRP) and peripheral blood white blood cell count(WBC) among patients with sepsis,bacterial infectious SIRS and local bacterial infection,we investigate the clinical application value of the serum PCT in bacterial infection.Methods:We select a sample of 63 hospitalized patients with suspected bacterial infections from August 2008 to October 2009 in our hospital.According to ACCP / SCCM consensus conference and relative clinical manifestion,patients are divided into three groups,including sepsis group(S group),bacterial infectious SIRS group(NS group) and local bacterial infection group(N group).All patients are determination the level of serum PCT,HSCRP,and WBC before treatment,after the use of antibiotics for 24h,5 days,10 days and before discharge.Results:1.In pre-antibiotic treatment,serum PCT doesn't increase in the local bacterial infection group(N group),mildly increase in the bacterial infectious SIRS group(N group) and significantly increase in sepsis group,while the hsCRP and WBC are significantly increased in the bacterial infectious SIRS group(NS group) and sepsis group(S group).2. In pre-antibiotic treatment,Serum PCT levels of Sepsis group(S group) are significantly higher than that of bacterial infectious SIRS group(NS group) and there exist significant differences between the two(p＜0.01), but WBC,hsCRP show no significant difference(P＞0.05);PCT,HSCRP, WBC of bacterial infectious SIRS group(NS group) are much more higher than those of local bacterial infection group(N group) and there also exist significant differences between the two(p＜0.05).3.To dynamic observate PCT,hsCRP and WBC of Sepsis group(S groups), We find serum PCT can rapidly increase at the early infection. Furthermore,when the infection is controlled after using the antibiotic for 5days,PCT can also be quickly come down.However,hsCRP,WBC remain high after controlling the infection and they decline slower than serum PCT.4.PCT has a good sensitivity(95.2%) and specificity(100%) in sepsis group(S group),and they are all higher than those of hsCRP and WBC.Conclusion:1.Detection of serum PCT could serve as the early diagnosis indicator of bacterial infection,Serum PCT for the diagnosis of sepsis has a high sensitivity and specificity.2.Detection of serum PCT can dynamically monitor the state of an illness in patients with sepsis, reflect the severity of bacterial infection,and provide objective evidence for clinicians to assess the disease prognosis.Its results are superior to hsCRP and WBC.3.The results of serum PCT test can reflect the efficacy of antibiotics,and provide guides for clinicians to adjust the antibiotics in time.