Comparison Of The Values Of PCT,CRP And Endotoxin In Early Diagnosis Of Severe Acute Pancreatitis Complicated With Bacterial Infection

Objective Dynamic detection of serum levels of procalcitonin,C-reactive protein and endotoxin in patients with severe acute pancreatitis complicated with or without bacterial infection.To campare the values of the three detection indexes in early clinical diagnosis.Methods 80 cases of SAP patients in department of gastroenterology were collected from January 2013 to January 2015.According to the criteria of infection diagnosis,the patients were divided into SAP with bacterial infection group(53 cases)and non-infected group(27 cases).The serum levels of PCT,C RP and endotoxin were measured in 24 h and 48 h after hospitalization respectively,and the length of hospital stay a nd cost of hospitalization were recorded.Results 1.At 24 h after hospitalization,the PCT level in SAP combined bacterial infection group was significantly higher than that in non-infected group,the difference was statistically significant(P<0.05),although the endotoxin and C RP level was higher than non-infected group,the differences were not statistically significant(P>0.05).At 48 h after hospitalization,the serum levels of PCT,CRP and endotoxin in SAP combined bacterial infection group were significantly higher than that in non-infected group,the differences were statistically significant(P<0.05).2.At 24 h after hospitalization,the sensitivity of PCT,endotoxin and CRP in SAP with infection group were 84.91%,73.59% and 64.15%,while the specificity were 92.59%,74.07% and 66.67% respectively.And the sensitivity of PC T,endotoxin and CRP were 100%,77.36% and 100%,and the specificity were 48.15%,88.89% and 81.48% respectively at 48 h after hospitalization.At 24 h after hospitalization,the sensitivity and specificity of PCT reached the highest level,but its specificity began to decline with the prolongation of hospitalization.3.At 24 h after hospitalization,the AUC of ROC curves of PCT,endotoxin and CRP were 0.972,0.732 and 0.613 respectively.The AUC of PC T curve was more than 0.9,which means a higher diagnostic value.While at 48 h,t he AUC of ROC curves of PC T,endotoxin and CRP were 0.828,0.850,0.810 respectively,all of which was over 0.8 and had diagnostic value.4.For the SAP patients with infection at 24 h after hospitalization,the method of PCT test was superior to endotoxin method(?~2=4.17,P<0.05),the PCT test was superior to CRP method(?~2=4.76,P<0.05),showing significant statistic difference.While no significant difference was observed between endotoxin and CRP tests(?~2=1.96,P>0.05).Conclusion Compared with C RP and endotoxin,the serum PCT level of SAP patients with bacterial infection has higher sensitivity for disease prediction,especially to the patients within 24 hours after hospitalization.It has important clinical value for early diagnosis and timely adjustment of antimicrobial therapy for the SAP with bacterial infection.