Clinical Significance Of Serum Procalcitonin In Assessing The Severity And Prognosis Of Traumatic Wet Lung

Objective: To early assess the diagnostic and prognostic siginificance ofprocalcitonin(PCT) and discuss the relations among concentrations ofPCT and severity and mortality in patients with traumatic wet lung by detecting PCT.Methods:56patients with traumatic wet lung from March2009to March2011wereselected from the department of intensive care in first affiliated hospital ofUniversity of south china. Those patients were devided into the light-moderate andsevere lung injury group lung injury group (grouping criteria are as follows).1.Inclusion criterias were as follows:①Age≥16;②diagnosis are in line with2006acute lung injury acute respiratory distress syndrome diagnosis and treatmentguidelines;③Require admission to the ICU intensive care,2.Experimental groups:1) By lung injury score (LIS) classification method (see Table1) divided into:①light-moderate lung injury group:0.1<LIS <2.5,②Severe lunginjury group: LIS≥2.5;2) By reference to clinical outcome and clinical pulmonaryinfection score (see Table2) divided into:①Lung infection group;②Non-pulmonaryinfection group;3) According to death within21days of follow-up is divided into:①Non death group;②death group:12healthy cases who selected from the hospitalare as control group.Age, gender and other aspects of the traumatic wet lung groupdid not differ significantly. Blood samples were collectedfrom each group whenentering into the ICU immediately,1d,3d,7and21d respectively. To detect serumPCT concentrations by enzyme-linked immunosorbent.Results:The correlation analysis of immediately lung injury score, acute physiology andchronic health score (acute physiology and chronic health, APACHE-Ⅱ)(see Table3)of Control group, light-moderate group and severe lung injury lung injury groupwhen entering into the ICU with PCT. Severe lung injury group into the ICU immediately lung injury score wassignificantly higher than light-moderate trauma group (P <0.01); Light-moderateand severe lung injury group into the ICU immediately lung injury group wereassociated with lung injury score was positively related to PCT (respectively r=0.862,P <0.01; r=0.884, P <0.01).light-moderate trauma group, severe lung injury group within1d APACHE-Ⅱscore higher, the difference was statistically significant (P<0.01), Comparing Withlight-moderate trauma group, APACHE-Ⅱ score of severe lung injury group,increased significantly (p <0.01).The two groups of APACHE-Ⅱ score werepositively associated with the PCT in1d(respectively r=0.713, P <0.01; r=0.792, P<0.01).2. The peripheral PCT of the control group, mild-moderate and severe lunginjury group at different time points①Compared with the control group, PCT of the light-moderate trauma groupand the evere lung injury group in the ICU immediately,1d,3d,7and21days wereincreased,(P <0.05); Compared with mild-moderate trauma group, severe lunginjury group in the ICU immediately,1d,3d,7days PCT peripheral blood increasedsignificantly (P <0.05).②In the light-moderate trauma group and the group withsevere lung injury,1d,3d,7days PCT was higher than the peripheral blood into theICU immediately, the difference was statistically significant (P <0.05). At1d,3dblood PCT was significantly higher than other time points, the difference wasstatistically significant (P <0.01).3.The peripheral PCT of the control group, non-infected group and infected groupat different time points①Compared with non-infected, infected group into the ICU immediately,1d,3d,7days PCT peripheral blood increased significantly (P <0.05).②In the non-infectiongroup,when entering into the ICU immediately,1d,3dPCT is higher than the first7,21days in peripheral blood (P <0.05),entering ICU immediately,1d,3d PCT was nosignificant difference in peripheral blood (P>0.05). In the infected group, comparedwith other point in time, into the ICU immediately,1d,3dPCT significantly increased in peripheral blood (P <0.01), and1d,3d PCT was significantly higher than theperipheral blood into the ICU immediately, the difference was statisticallysignificance (P <0.05).4. Comparation of the mortality of light-moderate and severe lung injury groupwithin21daysThe mortality rates of light-moderate group and severe group were12.5%and40.6%within21days,the difference was statistically significant (P <0.05)5.non-death group and death group at different time points in peripheral blood PCT:①compared with non-fatal, the death set into the ICU immediately,1d,3d,7days PCT were elevated in peripheral blood,(P <0.05).②In the death group,peripheral blood of the PCT when entering into the ICU immediately,1d,3d,7daysincreased. Each time point differences were statistically significant (P<0.05), and day7were significantly higher than other time points (P <0.01).Conclusions:1. the serum PCT concentrations of early (3d period) can determine objectively inpatients with traumatic wet lung disease severity.2. The traumatic wet lung patients with higher serum PCT in early (3d period) are ingreater the risk in nosocomial pneumonia;3. PCT in low concentrations in patients with traumatic wet lung did not affectmortality.The risk of traumatic wet lung patients was greater as progressiveincrease in serum PCT,.