The Clinical Study Of Severity And Prognostic Assessment Of Procalciton In Critical Patients With Bacterial Infections Received Anticoagulant Therapy In Intensive Care Unit

Objective:To investigate the feasibility of severity and prognostic assessment of Procalciton in critical patients received anticoagulant therapy with bacterial infection in Intensive Care Unit.Method:1. During October to December 2010, we observed 24 severe infected patients or suspected infected patients who accept anticoagulant therapy in EICU of the First Affiliated Hospital of Kunming Medical College,record the acute physiology and chronic health evaluation(APACHEâ…¡) and sequential organ failure assessment(SOFA). Monitored daily vital signs,c-reactive protein (CRP),coagulation index,blood routine,blood gas analysis,routine biochemistry. Monitored procalciton (PCT) in every other day. The PCT level was measured by fluorescence immunoassay.CRP level was measured by immunoturbidimetry.2.In the first 24 hours,24 patients according to severity are divided into 3 group: A,B,C.The differences of serum PCT and CRP levels,year,APACHEâ…¡and SOFA scores were compared in groups.Recevier operating characteristic curves (ROC curve) were drawn and compared serum PCT and CRP in early diagnosis of sepsis.3.24 severe patients according to its prognosis were divided into death group and live group, compared APACHEâ…¡score, SOFA score,PCT level, CRP level and age.4.Each of the serum samples corresponding to APACHEâ…¡scores, SOFA scores, PCT and CRP levels were carried out the relevant analysis.Result:1.In the first 24 hours, the pct level, APACHEâ…¡and SOFA scores were increased in septic patients and progressively elavated by the severities of sepsis patients(P<0.05), however, Year and CRP levels were not significant different(P>0.05). The area under ROC curve(AUC) of serum PCT Was bigger than serum CRP. 2.The death group compared with the survival group were significantly different APACHEâ…¡scores and SOFA scores(P<0.01).The pct level was significantly different between death group and survival group(P<0.01). The difference of pct level and years between death group and survival group were no difference(P>0.01).3. All serum samples of those confirmed or suspected bacterial infection severe patients received anticoagulant therapy showed a correlation between serum PCT and CRP. The pct level positively correlated with APACHEâ…¡and SOFA(r1=0.358;r2=0.350, P< 0.01).The CRP level had no correlation with PACHEâ…¡and SOFA(r1=0.097;r2=0.020, P> 0.05).conclusion:1. Anticoagulation therapy did not affect the judgment of serum PCT to severity and prognosis in infected patients.2. In early time of infeted patients which received anticoagulant therapy, the diagnosis of bacterial infection and severity were evaluated by PCT level.3.For the ICU infected patients,serum PCT has a positive correlation with APACHEâ…¡score and SOFA score,And has a certain significance on the prognosis of infected patients received anticoagulant therapy.4.Serum PCT in the evaluation of disease severity better than serum CRP in sensitivity and practicability.