The Study Of Prognostic Significance Of Serum Procalcitonin Levels In Patients With Sepsis

Objective To investigate the prognostic value of serum procalcitonin(PCT) levels in patients with sepsis.Methods 228 cases were collected from Tianjin Medical University General Hospital emergency medicine ward from April 2012 to March 2014. According to the prognosis, the cases were divided into survival group and death group, comparing each group with PCT, white blood cell(WBC) and C-reactive protein(CRP); according to the level of admission PCT,divided into 4 groups, PCT <0.05(normal group), 0.05≤PCT<2(mildly elevated group), 2≤PCT <10(apparently elevated group) and PCT≥10 ng/m L(extremely elevated group), comparing each group’s age, PH, Pa CO2, Pa O2, lactic acid(Lac), HCO3-, base excess(BE), WBC, N, Plt, CRP, erythrocyte sedimentation rate(ESR), creatinine(Cr), albumin(ALB), D-Dimer, cortisol(Cor), mortality, length of hospital stay and bacterial culture results. Statistical analysis: SPSS 17.0 software was used for statistical analysis. The data were performed l-K-S normal distribution test. Normal distribution of measurement data as mean ± standard deviation( x ±s). Two independent samples use t test, and four groups were compared using One-way ANOVA analysis of variance. Pairwise comparisons using Scheffe test. The non-normal distribution of the data using the median(quartile range), using the Mann-Whitney U test.Classified information use the ratio of number and using χ2 test. Correlation analysis using Spearman correlation. Draw the ROC curves to compare the size of the area under the curve. p<0.05 was considered statistically significance.Results 1.Death group and survival group PCT,(2.00[0.5,23.40]vs 0.67[0.21,3.93], p<0.05); WBC and CRP, P>0.05. 2.(1)PH: normal group and extremely elevated group(7.46±0.06 vs7.41±0.11, p<0.05); mildly elevated group and extremely elevated group(7.46±0.06 vs7.41±0.11, p<0.05).(2)Lac: normal group and apparently elevated group(1.15±0.71 vs 1.90±1.38, p<0.05); normal group and extremely elevated group(1.15±0.71 vs 2.64±1.99, p<0.05); mildly elevated group and extremely elevated group(1.53±1.38 vs 2.64±1.99, p<0.05).(3)HCO3-: normal group and apparently elevated group(25.55±4.18 vs22.34±4.05, p<0.05); normal group and extremely elevated group(25.55±4.18 vs 21.96±5.20, p<0.05); mildly elevated group and extremely elevated group(24.57±4.2 vs21.96±5.20, p<0.05).(4)BE: normal group and extremely elevated group(1.83±3.84 vs-4.65±6.54, p<0.05); mildly elevated group and extremely elevated group(1.42±4.75 vs-4.65±6.54, p<0.05)(5)Plt: normal group and extremely elevated group(234.73±100.41 vs 164.49±107.39, p<0.05).(6)CRP: normal group and mildly elevated group(4.66±4.22 vs 9.00±7.06, p<0.05);normal group and apparently elevated group(4.66±4.22 vs 15.03±10.72, p<0.05);normal group and extremely elevated group(4.66±4.22 vs 14.44±8.06, p<0.05);mildly elevated group and apparently elevated group(9.00±7.06 vs 15.03±10.72, p<0.05);mildly elevated group and extremely elevated group(9.00±7.06 vs 14.44±8.06, p<0.05).(7)Cr:normal group and extremely elevated group(72.69±37.00 vs 150.02±213.83, p<0.05);mildly elevated group and extremely elevated group(79.52±66.31 vs 150.02±213.83, p<0.05).(8)mortality: normal group and extremely elevated group(0.135[10/74] vs 0.372[16/43], p<0.05); mildly elevated group and extremely elevated group(0.141[10/71] vs 0.372[16/43], p<0.05); apparently elevated group and extremely elevated group(0.175[7/40] vs 0.372[16/43], p<0.05).(9) age、Pa CO2、Pa O2 、WBC、N、ESR、ALB、D-Dimer、Cor、 length of hospital stay and bacterial culture results, P> 0.05. 3.PCT negatively correlated with PH,HCO3-,BE and Plt, r=-0.154,-0.322,-0.391,-0.331. PCT positively correlated with Lac,CRP and Cr, r=0.349,0.500,0.302. 4.The AUC of PCT in different levels were 0.451,0.470,0.208,0.815.Conclusion 1. Serum PCT is an indicator to determine the prognosis of patients with sepsis, CRP and WBC has no correlation with the prognosis of patients with sepsis. 2.PCT negatively correlated with PH,HCO3-,BE and Plt. The higher the PCT level was,the lower PH,HCO3-,BE and Plt was. PCT positively correlated with Lac,CRP and Cr. The higher the PCT level was, the higher Lac,CRP and Cr was. 3. PCT≥10 ng/m L level has a certain significance in judging the prognosis of patients with sepsis.