The Predictive Value Of Serum Amyloid A,Interleukin-6,Procalcitonin And C-Reactive Protein In The Diagnosis And Severity Evaluation Of Sepsis

Objective: To explore the application value of serum amyloid A（SAA）and interleukin-6（IL-6）,procalcitonin（PCT）,C-reactive protein（CRP）in the early diagnosis and severity judgment of sepsis.Methods: A total of 80 patients admitted to the Intensive Care Unit（ICU）of the First Affiliated Hospital of Bengbu Medical College from October 2020 to May 2021 were selected.All patients received SAA,IL-6,PCT,CRP,albumin,lactic acid,platelet,creatinine.All patients calculated Acute Physiology and Chronic Health Evaluation Ⅱ score（APACHE Ⅱ）and the Sequential Organ Failure assessment（SOFA）score.（1）According to the diagnostic criteria of sepsis,25 patients were divided into the non-sepsis group and 55 patients were divided into the sepsis group.The differences in age,sex,SAA,IL-6,PCT,CRP,albumin,lactic acid,platelet,creatinine,APACHE Ⅱ score,SOFA score and prognosis were compared between the two groups.ROC curve was drawn to evaluate the diagnostic efficacy of SAA and IL-6 alone or in combination with PCT and CRP for sepsis.Spearman correlation coefficient was used to analyze the correlation between SAA,IL-6,PCT,CRP and APACHE Ⅱ score and SOFA score.（2）According to the diagnostic criteria of septic shock,the sepsis group was divided into the common sepsis group（n = 25）and the septic shock group（n = 30）.The differences in age,sex,SAA,IL-6,PCT,CRP,albumin,lactic acid,platelet,creatinine,APACHE Ⅱ score,SOFA score and prognosis were compared between the two groups.The ability of SAA and IL-6 to evaluate the severity of sepsis was compared.Results: SAA,IL-6,PCT,CRP,APACHE Ⅱ score,SOFA score and mortality in sepsis group were significantly higher than those in non-sepsis group,and the differences were statistically significant（P<0.05）.According to ROC curve for the diagnosis of sepsis,the area under curve（AUC）and specificity of PCT were the highest when a single indicator was applied（0.852 and 80.3%,respectively）.The sensitivity of IL-6 was higher than that of CRP（94.4% and 97.2%,respectively）.The specificity of SAA combined with PCT was the highest（95.8%）.IL-6 combined with CRP had the highest sensitivity（100%）.The sensitivity of IL-6 combined with PCT was significantly higher than that of PCT alone（91.7% vs.86.1%）.Spearman correlation analysis showed that SAA was positively correlated with APACHE Ⅱ score and SOFA score（r = 0.276,r =0.342,P<0.05）;Il-6 was positively correlated with APACHE Ⅱ score and SOFA score（r= 0.538,r = 0.471,P <0.05）.SAA,IL-6,APACHE Ⅱ score,SOFA score and mortality in septic shock group were significantly higher than those in normal sepsis group,and the differences were statistically significant（P<0.05）.ROC curve showed that SAA had the highest specificity and low sensitivity（80% and 56%,respectively）when applied with a single indicator.PCT had the highest sensitivity（92%）.The specificity and sensitivity of IL-6 were high（76.7% and 80%,respectively）.The sensitivity of SAA combined with PCT reached the highest level（96%）.The specificity of IL-6 combined with PCT was higher than that of IL-6 and PCT alone（80% vs 76.7% and 70%）.Conclusions: 1.SAA and IL-6 have certain clinical value in the auxiliary diagnosis and evaluation of the severity of sepsis.The combination of SAA and IL-6 with PCT and CRP can improve the clinical value.2.In the auxiliary diagnosis of sepsis,IL-6combined with CRP had the highest sensitivity,and SAA combined with PCT had the highest specificity.3.In the evaluation of the severity of sepsis,SAA combined with PCT had the highest sensitivity,and IL-6 combined with PCT had the highest specificity.