Study On The Value Of Heparin Binding Protein In Diagnosing Sepsis And Predicting Its Severity And Prognosis

PurposesTo test the effectiveness of heparin binding protein(HBP)for the diagnosis of sepsis and to evaluate the value of HBP for the severity of organ failure and prognosis in sepsis.Method108 patients with suspected infection who visited the emergency department of Hunan Provincial People’s Hospital between June 2019 and December 2020 were selected,and 49 patients with physical examination in our hospital were selected as the healthy group during the same period.They were divided into local infection group(infection was present but did not progress to sepsis),sepsis group,septic shock group according to sepsis 3.0 criteria.Basic information of the patients,including gender,age,white blood cell count(WBC)on admission,C-reactive protein(CRP),procalcitonin(PCT),HBP,sequential organ failure assessment(SOFA)score,quick SOFA(q SOFA)score,and the modified early warning score(MEWS);The current vasoactive drug application and recent medication history of the patient were also recorded;Patients were followed for survival through 28 days after admission.Groups were compared for the differences of the above indicators,and the area under the curve(AUC)of the receiver operating characteristic curve(ROC)was calculated to evaluate the diagnostic ability of each indicator.ResultsThe level of HBP in sepsis group was significantly higher than that in local infection group(median 34.43 ng/m L vs 15.99 ng/m L,P <0.01);And,the level of HBP in septic shock group was significantly higher than that in sepsis group(median 71.19 ng/m L vs 34.4 ng/m L,P <0.01).The HBP level was positively correlated with SOFA score,which was stronger than CRP and PCT(r: 0.6 > 0.38 > 0.33).Among those who developed sepsis,HBP levels were significantly different between those who survived(n=70)and those who died(n=17)(P < 0.01).When the cut-off value of HBP was ≥19.11 ng/m L,the AUC for the diagnosis of sepsis was 0.91[95% confidence interval(95% CI)= 0.873-0.96],which was greater than that of PCT(0.87)and CRP(0.79);Then,when the cutoff value of HBP was ≥39.21 ng/m L,the AUC for the diagnosis of septic shock was 0.69(95% CI = 0.574-0.809),which was less than that of the SOFA score(0.77).ConclusionHBP is a good diagnostic indicator for sepsis and septic shock.It has a good value in predicting organ damage and short-term prognosis of patients with sepsis.