The Plasma Levels And The Predictive Value Of PCT,TNF-α,IL-6 In Sepsis Patients After Multiple Trauma

Objective:To investigate the levels of serum PCT,TNF-α,IL-6 in patients after multiple trauma,discuss the realationship between PCT,TNF-α,IL-6 and multiple trauma with sepsis,to evaluate the predictive value of them in multiple trauma with sepsis.Methods:(1)The serum PCT,TNF-α,IL-6 were determined during the first 1h after admission in ICU.The serum procalcitonin concentration was measured in semi-quantitative detection by immunoluminometric assay(PCT-Q,BRAHMS Diagnostica,Germany),The serum tumor necrosis factor -αand interleukin-6 concentration was measured in quantity by enzyme linked immunoadsorbent assay(ELISA),Sensitivity, specificity,predictive values of procalcitonin in multiple trauma with sepsis and logistic regression analysis were evaluate.(2)Patients were divided into two groups:Sepsis group(S group 20cases)and non-Sepsis group(NS group 30 cases)according to whether or not complicating infection.Results:1.The serum-PCT,TNF-α,IL-6 at admission in ICU was significantly higher in multiple trauma patients with sepsis(media 3.0, range 1.0-4.0),(media 258.49,range 175.68-816.10ng/ml),(media 100.3,range39.55-149.27pg/ml)respectively,compared with non-Sepsis group(media 1.0,range 1.0-4.0),(media 116.53,range 21.55-369. 56ng/ml),(media65.89,range 15.98-150.86 pg/ml)respectively。2.Sensitivity,specificity,PPV,NPV of procalcitonin evaluate the predictive value of procalcitonin in multiple trauma with sepsis were 85.0%(17/20),80.0%(24/30),73.9%(17/23)and 88.9%(24/27) respectively.3.Logistic regression analysis of Serum-PCT,TNF-α,IL-6 were evaluate,their partial regression coefficient were 0.517,0.329,0.188 respectively.Conclusion:Multiple trauma patients with high serum-PCT, TNF-α,IL-6 levels are liable to sepsis;Serum-PCT and TNF-αmay be two reliable parameter for early diagnosis of sepsis after multiple trauma, and serum-PCT is superior than TNF-αand IL-6 as a valuable parameter with high sensitivity,specificity.