The Correlation And Clinical Assessment Significance Of Plasma Platelet Activating Factor And Cortisol Level In Patients With Sepsis

Objective: To investigate the expression of plasma platelet activatingfactor(PAF) and cortisol (Cor) level in patients with sepsis at admission toICU, the correlation of PAF with Cor level, as well as their relationshipwith illness severity and prognosis in patients with sepsis.Methods: Totally102patients with sepsis admitted to the ICU ofChongqing Emergency Medical Center from April2012to August2013were enrolled into sepsis group, which were divided into three subgroups:sepsis group(n=30), severe sepsis group(n=26)and septic shockgroup(n=46). All patients were divided into survivor group and nonsurvivor group according to their prognosis during hospitalization.40volunteers were selected as normal controls. The plasma PAF and Cor level,serum concentration of inflammatory biomarker procalcitonin (PCT) andcreatinine (Cr), acute physiology and chronic health evaluationⅡ(APACHEⅡ), simplified acute physiology scoreⅡ(SAPSⅡ) andsequential organ failure assessment (SOFA) scores of patients at admission to ICU in different subgroups were compared. The correlation of plasmaPAF with Cor level in control group, all the patients with sepsis, and allsubgroups were analyzed, respectively. The correlation of plasma PAF andCor level with serum concentration of PCT and Cr, scores of APACHEⅡ,SAPSⅡ and SOFA were also analyzed, respectively. The plasma PAF andCor level in survivor and non survivor group were compared, receiveroperating characteristics (ROC) curve were built to compare the assessmentsignificance of plasma PAF, Cor level and APACHEⅡ score for theprognosis in patients with sepsis.Results: Both plasma PAF and Cor levels were significantly higher insepsis group than in control group (P<0.05), and the PAF level wassignificantly higher in septic shock group than in sepsis and severe sepsisgroup(P<0.05), while there was no statistically difference in PAF levelbetween sepsis group and severe sepsis group (P>0.05), there was nostatistically difference in Cor level among sepsis group, severe sepsis groupand septic shock group (P>0.05). Plasma PAF level was not correlated withCor level in control group (r=-0.139, P>0.05), while plasma PAF levelswere positively correlated with Cor levels in all patients with sepsis,including sepsis group, severe sepsis group, septic shock group, survivorgroup and non survivor group (r=0.599,0.498,0.783,0.664,0.584,0.733,P<0.05). Plasma PAF level of patients with sepsis was positively correlatedwith the serum concentration of PCT and Cr, scores of SAPSⅡ and SOFA (r=0.376,0.381,0.326,0.483, P<0.05), while it was not correlated withAPACHEⅡ score (r=0.143, P>0.05). Plasma Cor level was not correlatedwith the serum concentration of PCT and Cr, scores of SAPSⅡ, SOFA andAPACHEⅡ(r=0.171,0.177,0.067,0.144,-0.019, P>0.05). Both plasmaPAF and Cor levels of patients in non survivor group were significantlyhigher than that in survivor group (P<0.05). Receiver operatingcharacteristics(ROC) curve showed that plasma PAF level, Cor level andAPACHEⅡ score of patients with sepsis at admission to ICU could beused as predictors of mortality during hospitalization(area undercurve=0.708,0.715,0.787, P<0.05).Conclusion: The expression levels of both plasma PAF and Cor wereincreased in patients with sepsis. Plasma PAF level was positivelycorrelated with Cor level in patients with sepsis at admission to ICU. PAFlevel of patients with sepsis is correlated with illness severity, while Corlevel is not significantly correlated with illness severity. Both PAF and Corplasma levels in patients with sepsis could be used to predict the prognosisof patients during hospitalization.