Diagnostic Value Of Heparin-binding Protein In Sepsis

Objective To observe the level of heparin-binding protein in the plasma of patients with sepsis. To investigate the clinical value of blood plasma heparin-binding protein in diagnosis of sepsis and compare the diagnostic performance of heparin-binding proteins with procalcitonin and C- reactive protein in sepsis.Methods Twenty healthy volunteers, 79 non-septic patients, 55 sepsis and 42 severe sepsis patients were enrolled to measure the levels of HBP as well as PCT and hs-CRP in their blood plasma. Then the differences of these three substances among healthy volunteers, non-septic patients, patients with sepsis and severe sepsis patients were compared and receiver operating characteristic curve was constructed to calculate the area under the curve and obtain the best cutoff value, sensitivity, specificity, negative predictive value and positive predictive value of these three substances when used to diagnose sepsis. The correlation of the levels of blood plasma HBP with PCT and hs-CRP as well as PCT and hs-CRP was analyzed at last.Results The mean levels of blood plasma HBP in control group, non-septic, sepsis and severe sepsis group were 2.14±1.98, 11.85±11.06, 10.43±10.21 and 104.97±106.84(ng/ml), PCT were 0.03±0.01, 0.12±0.06, 0.78±0.5 and 17.24±23.21(ng/ml), and hs-CRP were 0.97±1.37, 13.82±26.28, 40.14±32.8 and 100.82±66.83(mg/L), respectively. There was significant difference of blood plasma PCT and hs-CRP level among each two of the groups(P<0.01). However only sepsis group and the severe had significant difference about blood plasma HBP level(P<0.01). Moreover the receiver operating characteristic curve showed that the area under the curve about plasma HBP was 0.694. And when HBP level was 11.5ng/ml,the sensitivity and specificity reached to 73.2% and 64.9% respectively. While when HBP level was 28.9ng/ml the sensitivity and specificity to diagnose severe sepsis reached to 89.3% and 94.7% respectively and the negative predictive value and positive predictive value was 96.5% and 90.6% respectively. Bivafiate correlation analysis showed that a positive correlation was found between PCT and HBP level(r=0.874,P<0.01). There was no linear relationship between hs-CRP with HBP and PCT.Conclusion The levels of HBP, PCT and hs-CRP in blood plasma could be used to detect sepsis and evaluate the seriousness of this disease.When the concentration of HBP was 28.9ng / ml,the sensitivity and specificity to diagnose severe sepsis reached to 89.3% and 94.7% respectively and the negative predictive value and positive predictive value was 96.5% and 90.6% respectively.The level of HBP in blood plasma may be good biomarker of severe sepsis that can be used to monitor the progress of the disease sepsis. Detection of plasma HBP combined with PCT and analyzed the correlation between the two can better predict the occurrence of sepsis.