Clinical Study Of Change Of SCD14 And Its Significance In Sepsis Patients

ObjectiveThe aim of this study was to investigate the dynamic change of sCD14 in sepsis and its clinic values.Methods:It was a prospective study with 50 study population.The serum sCD14,PCT,CRP and WBC were tested at the emergency presentation and the followed 12h,24h and 48h.The clinical data were collected,including primary diagnosis,Acute Physiology and Chronic Health Evaluation ?(APACHE ?),Sequential Organ Failure Assessment(SOFA),severity of sepsis,ICU length of stay,blood culture results and 28-day mortality.The variation tendency of the sCD 14 in the whole sepsis patients was described.Besides,the variation tendency among different outcomes groups and different severity groups were analyzed.The correlations of sCD14 and APACHE ?,sCD 14 and SOFA were analyzed.ROC analysis was used to evaluate the values of serum sCD14,PCT,CRP and WBC on prognostic prediction of sepsis.Logistic regression analysis was also used to evaluate the relationship of serum sCD 14 and outcomes.Results:1)During the study periods,50 patients were finally enrolled in the study.Of the 50 patients,24 were male and 26 were female.The age of these patients was 54.68±9.31,range from 34 to 69.The infection sites were:22 of respiratory system,13 of digestive system,6 of unitary system,5 of nervous system and 4 of skin soft tissues.The positive blood culture was found among 16 patients.Finally,13 patients were died including 7 male and 6 female and the left 37 survival patients included 17 male and 20 female.2)The serum sCD 14 level increased from the first test at zero time point to the followed 48h.Compared to the survival group,the serum sCD 14 levels were higher at different time points among mortality group.3)The serum sCD 14 level increased with the severity of sepsis.4)The AUCs of sCD14 for prognostic prediction were 0.838 at zero time point,0.816 at 12h.0.808 at 24h and 0.946 at 48h.4)Compared to the patients with SOFA<2,the serum sCD14 levels were higher at different time points among patients with SOFA>2.5)Besides,the serum sCD14 levels were also higher in patients with higher APACHE ?.6)The serum sCD14 level was correlated with CRP at zero time point,correlated with WBC at 12h point,correlated with PCT,APACHE II with SOFA at 24h point and correlated with PCT at 48h point.7)According to Logistic regression analysis,APACHE II and serum sCD14 level were important predictors of outcomes.Conclusion:The increasing of sCD14 may be a useful serum marker on evaluating the severity and prognosis in sepsis.The serum sCD14 at admission was important predictor of outcomes.