Significance Of Serum HS-CRP And PCT Levels In Diagnosis Of Sepsis In Burn Patients

Objective:China has a large population base,and the problem of aging is becoming more and more serious.The number of burn patients is numerous.Burn with sepsis are the main causes of death in burn patients.Early diagnosis and timely intervention are the main focus point of current burns with sepsis.This article aims to investigate the value and characteristics of hs-CRP,PCT levels in predicting and assisting in the diagnosis of sepsis.Methods:This study included 103 patients admitted to the Department of Burn and Plastic Surgery of Yan’an University Affiliated Hospital from March 2017 to December2018.Among them,56 patients with burns were infected as control group,and 47 patients with burns and sepsis were observation group.The observation group was divided into three groups,including 23 in the SIRS2 group,15 in the SIRS3 group,and 9in the SIRS4 group.According to the results of blood bacterial culture,the observation group was divided into 19 cases of Gram-positive bacteria group and 28 cases of Gram-negative bacteria group.The clinical data of the patients were collected,including age,gender,total body surface area(TBSA),admission time,body temperature,heart rate,respiratory rate,etc.Laboratory data such as white blood cell count,hs-CRP value and PCT value were collected for statistical analysis.Results:The serum levels of hs-CRP and PCT in observation group were significantly higher than those in control group.The difference was statistically significant(P<0.05).There were significant differences in serum hs-CRP levels between the SIRS2,SIRS3 and SIRS4 subgroups in the observation group(P<0.05).Serum hs-CRP levels were significantly different between SIRS2 group and SIRS3 group,SIRS2 group and SIRS4 group(P<0.05).There was no significant difference in serum hs-CRP levels between SIRS3 group and SIRS4 group(P>0.05).There were significantdifferences in serum PCT levels between SIRS2,SIRS3 and SIRS4 subgroups(P<0.05).There were significant differences in serum PCT levels between the three subgroups(P<0.05).There was no significant difference in serum hs-CRP levels between GN group and GP group in the observation group(P>0.05).There was a statistically significant difference in PCT levels between GN group and GP group(P<0.05).The area under the ROC curve(AUC)of serum hs-CRP in the diagnosis of GN bacteria Sepsis was 0.632,and the optimal diagnostic threshold was 33 mg/L,the sensitivity was 67.86%,and the specificity was 63.16%.The AUROC of serum PCT in the diagnosis of GN bacteria sepsis was 0.809,and the optimal diagnostic threshold was 2.95 ng/ml,the sensitivity was 82.14% and the specificity was 78.95%.Conclusions:Burns combined with sepsis have a significant impact on the prognosis of burn patients.Serum hs-CRP and PCT levels can be used as indicators of infection in patients.Serum PCT levels are more specific for the diagnosis of burn patients with sepsis.Serum PCT levels are more valuable in making clinical diagnosis of sepsis.At the same time,the serum PCT value is more sensitive and specific for the diagnosis of patients with GN bacterial sepsis.For burn patients suspected of having sepsis,fully evaluate the general condition of patients,and early detection of hs-CRP,PCT and other related markers,combined with the patients’ own condition,early diagnosis of sepsis,and appropriate treatment,can reduce the mortality rate of sepsis better.