A Correlation Study Between PCIS And The Level Of PCT, Hs-CRP In Acute Phase Of Sepsis In Children

Objective:To investigate the correlation between pediatric critical illness score (PCIS) and the serum level of PCT, Hs-CRP in acute phase of sepsis in children, then evaluate its value of clinical application in order for the early diagnosis of sepsis, making judgment for critically ill patients, and providing theoretical basis for timely intervention.Methods:Using prospective study method to collect 63 cases of sepsis and 30 cases of non-infection SIRS children, who were admitted to the Second Affiliated Hospital of Kunming Medical University between June and December 2015, as the research objects. All of them were checked for serum level of PCT and Hs-CRP within 24 hours after admission by using quantitative method of drying immunofluorescence, and the patients were scored simultaneously with PCIS. The SPSS 19.0 software was applied for statistical analysis.Results:1. Comparison of age and gender between sepsis and non-sepsis group:the age of Sepsis and Non-sepsis group M (P25, P75) were 1.420 (0.750,0.750) and 3.835 (1.040, 1.040), respectively. Comparing these two groups, there was no statistical difference in age (P>0.05). The gender (male%, female%) of these two groups were (47.6%.52.4%) and (60.0%, 40.0%). respectively; and the comparisons had no statistical significance in gender (P>0.05).2. Comparison of PCT, Hs-CRP, and PCIS in acute phase of sepsis and non-sepsis group:the PCT levels of sepsis and non-sepsis group were 4.175± 4.184 ng/ml and 0.967±0.559 ng/ml, respectively. The serum level of PCT in sepsis group was higher than that of non-sepsis group, there was statistical difference (P>0.05). In addition, Hs-CRP levels of sepsis and non-sepsis group were 50.935±41.088 mg/L and 38.963±35.222 mg/L, respectively. And the comparison of Hs-CRP between these groups had no statistical significance (P>0.05). Furthermore, the PCIS of sepsis and non-sepsis group were 82.857±8.165 point and 91.733±4.448 point, respectively. And the PCIS of sepsis group were lower than non-sepsis group’s, there was statistical difference (P<0.05).3. Comparison of PCT, Hs-CRP and PCIS in acute phase of bacterial sepsis and non-bacterial sepsis group:the PCT levels of bacterial sepsis and non-bacterial sepsis group were 6.280±4.206 ng/ml and 0.974±0.510 ng/ml, respectively. The serum PCT level in bacterial sepsis group was higher than that of on-bacterial sepsis group, there was statistical significance difference (P<0.05). Moreover, Hs-CRP levels of bacterial sepsis and non-bacterial sepsis group were 58.407±45.129 mg/L and 39.556±31.616 mg/L, respectively. And the comparison of Hs-CRP level between these two group had no statistical difference (P>0.05). What’s more, PCIS of bacterial sepsis and non-bacterial sepsis group were 81.821±8.053 point and 85.040±8.003 point, respectively. The PCIS of bacterial sepsis was slightly lower than that of non-bacterial sepsis group, there was no statistical significance (P>0.05).4. Comparison of PCT and Hs-CRP level in non-critical, critical and extremely critical groups of sepsis in acute phase:the PCT and Hs-CRP levels of non-critical, critical and extremely critical groups were (1.189±0.639 ng/ml; 25.939±34.743 mg/L), (6.093±3.217ng/ml; 48.332±32.537 mg/L) and (13.660±1.887 ng/ml; 104.396±77.823 mg/L), respectively. The comparison of serum PCT and Hs-CRP in these three groups had statistical significance differences (P<0.05).5. Correlation of PCT and Hs-CRP levels with PCIS in acute phase of sepsis: PCIS had a significant negative correlation with serum PCT (r=-0.471,P<0.05) and Hs-CRP (r=-0.385, P<0.05) level.Conclusions:1. PCIS is still one of the valuable indicators for physiological scoring of sepsis in acute phase for children. PCIS is simply to calculate for critical illness, and also easily to promote.2. PCIS has a negative correlation with serum PCT and Hs-CRP level in acute phase of sepsis in children. The serum PCT and Hs-CRP level can reflect the degree of critical illness in acute phase of sepsis. The correlation between PCIS and serum PCT is lower than that of with Hs-CRP. Thus, the PCT index is greater than Hs-CRP index for diagnosing sepsis in acute phase of children in critical illness.3. The detection of PCT index enables to early identify between sepsis and non-sepsis. It also can be used to differentiate between bacterial and non-bacterial infection, combined with PCIS can help to better evaluate the degree of infection. Whereas Hs-CRP index can not independently predict the occurrence of sepsis. It has some limitation for differentiating between bacterial and non-bacterial infection of sepsis.