The Clinical Value Of Soluble CD14-st Detection In Patients With Acute Paraquat Poisoning

Objective: To investigate the relationship between soluble CD14-st Presepsin)and assessment,prognosis in patients with acute paraquat poisoning(APP).Methods: A total of 54 patients with APP treated in Emergency Department of Harrison International Peace Hospital Affiliated to Hebei Medical University from Oct.2015 to Oct.2016 were divied into three groups:mild poisoning group(13cases),moderate poisoning group(24cases)and severe poisoning group(17cases).According to the difference in prognosis,divied into survivor group(18cases)and non survivor group(36cases).Another 20 healthy persons were selected as control group.Venous blood of3 ml were collected on physical examination of the control group,Venous blood of 10 ml were collected on all patients before and 72 hours,7 days after treatment to detect presepsin.Venous blood were collected of all patients to detect C reactive protein(CRP),tumor necrosis factor a(TNF-a),interleukin-6(IL-6)and interleukin-10(IL-10)in plasma were measured.Before and 72 hours,7 days after treatment,the change of Acute physiology and chronic health evaluation(APACHE)?score and the outcomes in 28 days were observed.The variance analysis of repeated measures was used to compare the two groups,and the t test was used in the comparison between the two groups to compare changes of detection index,the outcomes in 28 days were compared with chi square test.Pearson correlation test was used to analyze the correlation between Presepsin in patients with APP and the survival rate.Results: APACHE?scores and the serum level of Prespsin,CRP,TNF-a,IL-6 at at admission and 72 hours,7 days after treatment in poisoning group were significantly increased compared with control group,IL-10 were decreased compared with control group(P<0.05),and there were significantdifference between moderate group and mild group,severe group and mild group,moderate group(P<0.05).At admission,72 h,7 d after admission,APACHE?score and the serum levels of Presepsin,CRP,TNF-a,IL-6 in non survivor group were higher than that in survivor group,IL-10 was lower than that in survivor group(P<0.05).The mortality rate of three groups were23.08%,70.83% and 94.12%,and there were significant difference between moderate group and mild group,severe group and mild group,moderate group(P<0.05).The AUCs were 0.862 and 0.731 for Presepsin and APACHE?score respectively at admission.The predictive ability for 28-day mortality of Presepsin was better than APACHE?score(P<0.05).The level of serum Presepsin in patients with APP was negatively correlated with the survival rate(r=-0.285,P=0.009).Conclusions: The detection of Prespsin has important clinical value to the severity assessment and prognosis in patients with APP.There is important guidance for early clinical drug application.