The Value Of Procalcitionin,CRP And AMY On Prognosis In Critically Ill Patients Assessment

Objective: Through detecting the blood PCT, CRP, AMY concentration,the critically ill patients who were in our hospital, were blood in the next couple of days.And the results were combined with acute physiology and chronic health evaluation II(APACHE II score).The purpose was to confirm the clinical significance of PCT, CRP, AMY level and APACHEII score for the assessment of critically ill patients about disease and prognosis.Methods:40 healthy subjects were selected from our hospital in 2014 August to 2015 February as control group,and 87 cases of patients were selected as treatment group at the same period. Their bloods were collected to measured the PCT, CRP, AMY levels in the first,third and seventh day after were admitted to hospital.The APACHE II scores were calulated in the 24 hours.We grouped the APACHEII scores into two types, death group and survival group,that the 28 days as a life cycle.And then to compare the blood PCT, CRP, AMY levels between the two groups.By analyzing the data to understand without statistically significant, which between the severe patients group and control group, patients with severe group according to the APACHE II group and death group and survival group. The purpose is to estimate the clinical significance of the three indicators about the severe patient’s condition and prognosis.Results:1 Critically ill patients, blood PCT, CRP, AMY levels were contrasted with the control group.There were statistically difference of statistical significance,P<0.01. 2 With the increase of the critically ill patients,the APACHE II scores increased, mortality rates were 29.8%、65%、80%; 3 Severe group of people,s PCT levers in the different time of admission and APACHEII scores were positively correlated(r = 0.458,0.569,0.629,P<0.01).Severe group ofpeople,s CRP levers in the different time of admission and APACHEII scores were positively correlated(r = 0.418, 0.622, 0.532, P <0.01).Severe group of people,s AMY levers in the different time of admission and APACHEII scores were positively correlated(r = 0.619, 0.521, 0.559, P<0.01). 4 The mean for each of the two were compared, the results are as follows:(1)The blood PCT levels at different time points between three groups were increased significantly by the APACHE II scores. The blood CRP levels at different time points between three groups were increased significantly by the APACHE II scores. The blood AMY levels at different time points between three groups were increased significantly by the APACHE II scores(2)Comparison between each two groups: The result of each comparison was remarkable statistically significant 5 Critically ill patients in different time of admission blood PCT, CRP,AMY level trend (1) the levels of serum PCT on admission were high normal, and later little falling gradually, then gradually falling to the end.(2) the level of blood CRP was high in the first day, rising fastest on the third day, rising lower on the seventh day.(3) the level of blood AMY were the normal on the first day, then gradually increased in the follow days, and on the seventh days,the blood AMY level was the highest. 6 Death group and survival group:different time points of PCT,CRP and AMY levels of death group were agreater degree of increased than the survival one, P <0.05, the result have statistical significance. 7 ROC curve area third days of serum procalcitonin activity was 0.952, 95% confidence interval 0.916~0.984, serum PCT level of 12.92ng/ml as a cut-off point to judge the prognosis of patients with severe symptoms was the best, specific degree was 89.6%, sensitivity was 88.5%.ROC curve area third CRP blood for 0.755,95% confidence interval 0.673~0.855, the blood levels of CRP and 42.923mg/L as a cut-off point to judge the prognosis of patients with severe symptoms was the best, specific degree was 52.1%, sensitivity was 96.1%.Area of third blood AMY curve was 0.781, 95% confidence interval 0.682~0.881, the blood AMY level for 255U/L as a cut-off point tojudge the prognosis of patients with severe symptoms was the best, specific degree was 82%, sensitivity was 68.6%.In the admission day APACHE II score for ROC curve, the area under the ROC curve was 0.924, 95% confidence interval 0.864~0.966, the blood APACHEII score of 21 as a cut-off point to judge the prognosis of patients with severe symptoms was the best, specific degree was81.2%, sensitivity was 87.3%.Conclusion:Compared with the control group, the blood PCT, CRP, and AMY levels of Patients,there were significant differences of statistical significance. Mortality was increased as the growth of APACHE II score. Critically ill patients were closely correlated to the APACHE II score and the PCT,CRP,AMY levels. Serum PCT,CRP,and AMY level on the prognosis of patients with severe disease has important clinical value.