Early diagnostic and prognostic value of procalcitonin in critical ill patients with sepsis
- VernacularTitle:降钙素原对危重症患者合并脓毒症早期诊断及预后预测的意义
- Author:
Ming-Gang WANG
;
Chun-Sheng LI
;
Jun YANG
;
Shuo WANG
;
- Publication Type:Journal Article
- Keywords:
Sepsis;
Critical illness;
Diagnosis;
Prognosis;
Procalcitonin
- From:
Chinese Journal of General Practitioners
2003;0(04):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the diagnostic value of procalcitonin(PCT)as an early indicator for sepsis.Methods Serum levels of PCT and C-creative protein(CRP)and white blood cell (WBC)count were measured in 30 patients in critical condition hospitalized at an intensive care unit(ICU) with diagnosis of systemic inflammatory response syndrome(SIRS).They were divided into two groups, sepsis and non-sepsis,based on their clinical manifestations and results of lab tests.Blood specimen was collected from each patient for measurement of PCT,CRP and WBC count on the 1~(st),3~(rd)and 7~(th)day after hospitalization and bacteriological culture for blood and sputum,and chest X-ray was performed,as well. Acute physiology,age and chronic health evaluation(APACHE Ⅱ)was made on the 1~(st),3~(rd)and 7~(th)day after hospitalization to assess their ill condition.Their prognosis were judged on the 28~(th)day of the follow-up. Results Serum level of PCT increased significantly in the sepsis group(with the highest of 10.13 ng/ml), as compared with that in the non-sepsis group.Sensitivity,specificity and predictive value of a positive test for a cut-off value of serum level of PCT at 0.5 ng/ml were 97.0%,91.7% and 82.1%,respectively, which were all better than those of serum level of CRP and WBC count.Serum level of PCT in the patients was significantly associated with their prognosis,and PCT in those died was significantly higher than that in those survived.Whereas,serum level of CRP and WBC count elevated in both groups,but the difference between the two groups did not reach a level of statistical significance.Conclusion Serum level of PCT can be used as an early indicator for judgment of sepsis for a patient with infection and reflection of severity of illness.