The Early Diagnostic Function Of Serum Procalcitonin For Sepsis In Critically Ill Patients

BackgroundSepsis and multiple organ dysfunction syndrome induced by infection are major causes of death in ICU patients. In the absence of a valid clinical or biochemical parameter, sepsis might be difficult to assure early in critical ill patients, which affect treatment and prognosis. Recent studies have shown that high serum concentration of procalcitonin (PCT) is related to severe bacterial and fungal infection, but the level of serum-PCT remains low in viral infection. So serum-PCT provide a new method for the early diagnosis of sepsis.ObjectiveTo investigate the change of serum PCT in critically ill patients with sepsis, compared with other inflammatory indicators.Methods(1)Sepsis is defined according to the ACCP/SCM consensus conference criteria. Patients were divided into two groups: Sepsis group (S group) and non-Sepsis group (NS group); (2)According to pathogen results, four groups were established: Gram-positive bacteria infection group(G+ group), Gram-negative bacteria infection group(G-group),mixed infection group (G+ G- ) and fungi infection group. Temperature, SBP, white blood cell, platelet count, FIO2/SPO2, APACHII score and serum-PCT were determined during the first 24h after admission. Use rank sum test and Student's t-test in SPSS software as the statistic methods.Resultsl)Seventy- five patients were studied. S group n=33, NS group n=42. Serum-PCT values were higher in ICU patients with sepsis. ( P<0.05 ). Other parameters such as temperature,SBP, white blood cell, platelet count, FKVSPOi. APACHII score did not differ significantly between sepsis group and non-sepsisgroup (P value is 0.298 ,0.134, 0.814, 0.202, 0.316,0.685 respectively).2)Among Gram-positive bacteria infection .Gram-negative bacteria infection, mixed infection group and fungi infection group, serum-PCT levels did not differ significantly. (P> 0.05 ). ConclusionsHigh serum-PCT levels are found in ICU patients with sepsis. There are no significantly different in serum-PCT among diverse types of infections. Thus serum-PCT may be a reliable parameter for the early diagnosis of sepsis in ICU patients, but serum-PCT can not ascertain infection nature.