Clinical Study On Diagnostic Value Of Serum Procalcitonin For Patients In Icu With Severe Infection, And Differential Diagnositic Value Of Abdominal Infection

Objectives： To assess the diagnosis and prognosis value of serum procalcitonin(PCT) for patients in the ICU with severe infections, and to clarify its differentialdiagnostic value in severe abdominal infection.Materials and Methods:During May2010to March2012, we observed48infectedpatients who admitted in ICU, the People’s Liberation Army General Hospital, whohad clearly local infection or suspected systemic infection, or Sepsis, or septicshock.Icluding32males and16females, aged23to99years old, the average age was55.6years.The individuals were unrelated,and were ruled out trauma, the first dayafter major surgery, pregnancy, underlying diseases of the immune system,etal.According to the site of infection, all patients were divided into abdominal infectiongroup(IAI), respiraty infection group (RI), central nervous system infection group(CNSI), urinary tract infection group (UTI).We recorded the patient’s generalsituation, take the results of the patient’s when the infections were definite andtargeted antibiotic treatment had not been used.Record the vital signs, arterial bloodgas analysis, blood routine, blood biochemistry, serum procalcitonin, C-reactiveprotein and bacteriological culture results,and the serum PCT at the end of treatment.Calculate the patients’ Acute Physiology and Chronic Health Evaluation (APACHEII)and SOFA score. Using enzyme-linked immunosorbent to assay serum PCT levels,the immune turbidimetric method to assay CRP levels.The APACHEII and SOFAmethods can be seen in the schedule.Using SPSS17.0software for data analysis,bilateral P <0.05was considered statistically significant.Result:1. The PCT value of the abdominal infection group(IAI), respiratory infectiongroup(RI), central nervous system infection group(CI) and the urinary tract infection group(UTI) were significantly higher than normal.and was positively correlated withAPACHEII and SOFA score.But the positive rate of diagnosis were withoutsignificant difference (P>0.05).2.The increased range of serum procalcitonin (PCT) levels of abdominal infectiongroup(IAI),respiratory infection group(RI), central nervous system infection group(CI)and the urinary tract infection group(UTI) were different, and the levels of abdominalinfection (IAI) were significantly higher than the other groups (P <0.05). TheAPACHEII score and other infection markers such as serum CRP level, WBC count,neutrophil ratio (N%), platelet count (PLT), brainnatriuretic peptide (BNP) of thepatients had no significant difference (P>0.05).Conclusion1. Serum procalcitonin (PCT) has the improtant role in the diagnosis and prognosis ofinfection of critically ill patients. The PCT values can reflect the severity of thedisease.2. The creasing range of serum PCT levels was largest in the abdominal infectiongroup(IAI) patients. Serum PCT has meaningful for the diagnosis of introabdominalinfection.