Study On The Diagnostic Value Of Different Laboratory Indexes For Sepsis

Objective: Retrospectively analyze the changes of routine laboratory indexes in patients with sepsis,and to explore the correlation between these indexes and the severity of the disease,as well as the diagnostic value for the prognosis of patients,so as to provide the basis for the diagnosis and treatment of sepsis,the progress of the disease and the judgment of prognosis.Methods: 1.The clinical and laboratory test data of 106 patients with sepsis and80 patients with SIRS in the first hospital of Lanzhou University from July 2017 to June2020 were collected;2.According to the condition,they were divided into general group,severe group and shock group;according to the prognosis,they were divided into poor prognosis group and good prognosis group.3.SPSS23.0 was used for statistical analysis.Results: 1.Infection sites and pathogenic bacteria of patients with sepsis: the main infection sites of patients with sepsis were respiratory system infection(31.13%),followed by multi system infection of two or more systems(29.25%),digestive system infection(17.92%),other infections(pelvic infection,lymphadenitis,etc.)(9.43%),urinary system infection(5.66%),postoperative infection(4.72%),unspecified infection(1.89%));A total of 65 strains of pathogenic bacteria were isolated from 106 patients with sepsis.The top three bacteria were Escherichia coli(23.08%),Klebsiella pneumoniae(10.78%)and Staphylococcus aureus(10.77%).2.In sepsis group and SIRS group,the levels of PCT,CRP,NEUT%,NLR,DD,FDP,APTT and LDH were increased,while the levels of RBC,HB,HCT,RDW,PLT,MPV,PDW,LYM%,AT,FIB,TP and ALB were decreased(P < 0.05).There was no significant difference in WBC,MONO%,PT and TT between the two groups(P > 0.05).3.There were significant differences in age,PCT,CRP,RBC,HB,RDW,PLT,MPV,PDW,LYM%,FIB,AT,TP,ALB,NEUT%,NLR,APTT,TT,DD,FDP and LDH levels among general sepsis group,severe sepsis group and shock group(P < 0.05).There were significant differences in NLR,PCT,PLT,PDW,MPV,APTT,DD,FDP,at and TP levels among the three groups(P < 0.05).There was no significant difference in HCT,WBC,MONO% and PT levels among the three groups(P > 0.05).4.There were significant differences in age,PCT,CRP,NEUT%,NLR,APTT,TT,DD,FDP,LDH,RBC,HB,RDW,PLT,MPV,PDW,LYM%,FIB,AT,TP and ALB between poor prognosis group and good prognosis group(P < 0.05).There was no significant difference in HCT,WBC,MONO% and PT levels between the two groups(P > 0.05).5.PLT,AT and DD had the highest diagnostic value for the prognosis of patients with sepsis(AUROC > 0.9),followed by FDP,LDH,PCT,TP,ALB and APTT(AUROC was 0.8-0.9),NEUT%,RDW,NLR,LYM%,HB,CRP,MPV,MPV+PDW and TT had the average diagnostic value for the prognosis of patients with sepsis(AUROC was 0.7-0.8),PDW,RBC,FIB and PT had no diagnostic value for the prognosis of patients with sepsis(AUROC < 0.7).Conclusion: 1.The changes of serum biomarkers,coagulation indexes,nutritional indexes and blood routine indexes are helpful to the diagnosis of adult sepsis;2.The changes of serum PCT,APTT,DD,FDP,AT,TP,PLT,MPV,PDW and NLR can reflect the condition and prognosis of patients with sepsis to a certain extent;3.DD,AT and PLT in serum have the highest diagnostic value for predicting the prognosis of patients with sepsis.