Copeptin, C-reactive Protein, Procakitonin Early Dynamic Monitoring Of The Value Of Sepsis

Obiective: Through the hospital patients with sepsis in the determination of ICU,admission plasma and peptide24hours,48hours after admission,72hours ofadmission, Copeptin, C-reactive protein, procalcitonin concentrations, and AcutePhysiology And Chronic Health EvaluationⅡ(APACHEⅡ), discussion Copeptin, C-reactive protein, procalcitonin early dynamic monitoring in the application value ofsepsis.Methods: During the period of2012May to2012December were selected in ourhospital EICU ward in41cases of sepsis patients as the research object. The APACHEⅡ score of these patients within24hours, and at the time of admission,24hours ofadmission,48hours of admission,72hours after admission were measured in plasmaCopeptin level, the level of CRP, PCT level; Based on APACHE II score were dividedinto three groups: Group I≦15points (9cases); GroupⅡ15~24points (8cases);Group Ⅲ for>25points (24cases); then according to whether the patients died within28days were divided into death group (26cases) and survival group (15cases).Application of statistical methods to compare differences in patients plasma copeptinlevel, CRP level, PCT level, and analyze the correlation.Results:1. The mortality of41cases of different sepsis score group and increased withincrease of APACHE Ⅱ score, respectively11.1%,62.5%,83.3%.2. By using Spearman analysis method on different time point detection Copeptinlevel, CRP level, PCT level and APACHE II score do correlation analysis found: atdifferent time points Copeptin hormone levels and APACHE Ⅱ score were positivelycorrelated (r=0.997,0.993,0.968,0.952, P <0.01); the level of CRP and APACHE Ⅱscore at different time points were positively correlated (r=0.948,0.887,0.808,0.807, P <0.01); the levels of PCT and APACHE Ⅱ score at different time points werepositively correlated (r=0.999,0.998,0.956,0.881, P <0.01).3. Q tests performed withα＝0.05,the results as follows:①Three groups atdifferent time points of serum copeptin levels along with elevated APACHE II scorewere increased, the sample mean is found: I, II group, P>0.05, the difference is notstatistically significant; compared with Ⅰ, Ⅲ group, P <0.05, the differences werestatistically significant; compared with Ⅱ, Ⅲ group, P <0.05, with significantdifference.②Three groups at different time points of serum CRP level with APACHEⅡ score rises were increased, the sample mean comparison every two were found: acomparison of different between the groups on admission, P>0.05, the difference is notstatistically significant; while24h,48h,72h admission, comparing Ⅰ, Ⅲ group, P<0.05, the difference was statistically significant; comparison of II, III group, P <0.05,the difference was statistically significant; after24h,72h, I, II group, P>0.05, thedifference is not statistically significant; after48h, Ⅰ, Ⅱ group, P<0.05, withsignificant difference.③Three groups at different time points of serum PCT level withAPACHE Ⅱ score rise increased, comparing Ⅰ, Ⅱ group, P <0.05, the differenceswere statistically significant; compared with Ⅰ, Ⅲ group, P <0.05, with significantdifference; comparison of II, III group, P <0.05, with significant difference.4. The comparison of two-sample t-test analysis,we found that: The score ofAPACHE Ⅱ sepsis patients death group was significantly higher than the survivalgroup, the difference was statistically significant (t=6.760, p<0.01); Plasma copeptin atdifferent time point detection levels, the death group was significantly higher than thatin the survival group, the difference was statistically significant.（t0h=6.158，t24h=6.283，t48h=6.998，t72h=6.844，p all<0.01）; The levels of CRP were detected atdifferent time points, the death group was significantly higher than that in the survivalgroup, the difference was statistically significant.（t0h=6.863，t24h=6.413，t48h=4.987，t72h=4.457，p all<0.01）; The levels of PCT were detected at different time points, thedeath group was significantly higher than that in the survival group, the difference wasstatistically significant.（t0h=6.867，t24h=5.575，t48h=6.589，t72h=6.114，p all<0.01）。5. Death in ICU patients with sepsis multivariate logistic analysis,the results showed that: in the factors of age, sex, APACHEⅡscore and admission, admission24hours, 48hours after admission,72hours of admission copeptin,CRP, PCT, on the death ofsignificant variables are APACHE II score,72hours after admission copeptin level, thelevel of CRP in48hours after admission,24hours PCT levels.(PAPACHEⅡ=0.000，Pcopeptin=0.002，PCRP=0.002，PPCT=0.002).Conclusion:1. Found in the experiment of plasma copeptin level, CRP level, PCT level andAPACHE II score were positively correlated, can be used as a good assessment index ofseverity of illness in patients with sepsis and prognosis.2. May the dynamic monitoring plasma copeptin level, CRP level, PCT level thanthe single detection more meaningful, helps to find the turning point of the illness.3. Compared to the APACHE Ⅱ data acquisition difficulties, characteristics ofplasma copeptin, CRP, PCT detection more efficient, simple, reproducible, can be usedas a condition assessment in patients with sepsis severity of early, sensitive index.