Utility Of The Fibrinogen/C-reaction Protein Ratio For The Diagnosis Of DIC Among Sepsis Patients

Objectives: To research the plasma concentration of the fibrinogen(FIB)in DIC of sepsis and determine if the fibrinogen/C-reactive protein ratio can be used to diagnosis disseminated intravascular coagulation in sepsis patients.Methods: The clinical data of 328 cases of the sepsis admitted from January 2017 to August 2018 in the ICU of the First Affiliated Hospital of China Medical University were analyzed retrospectively.Collect the fibrinogen、C-reactive protein(CRP)and variables of coagulation inclouding platelet(PLT),prothrombin time(PT),activated partial thrombopastin time(APTT)and APACHⅡscore and SOFA score which were detected in the first 24 hours after they were in ICU.According to ISTH score and JAAM score,divide the patients into two groups :sepsis with DIC and sepsis without DIC.The differences of FIB/CRP ratio,fibrinogen,CRP,PT,APTT,PLT,APACHⅡscore and SOFA score in the two group were analyzed by independent samples t test.The receiveroperating characteristics(ROC)analysis was performed to predict the diagnostic power of the variables fibrinogen and fibrinogen/C-reactive protein ratio.Results: NO matter according to the JAAM score or ISTH score,in sepsis with DIC group,the value of fibrinogen/C-reactive protein ratio and PLT were lower than sepsis without DIC group(P<0.05).C-reactive protein,SOFA score,APACHⅡsocre,PT,APTT were higher in sepsis with DIC group(P<0.05).And there is no distinction of fibrinogen in the two groups(P>0.05).When the diagnositic criteria is the ISTH socre,the area under the cure of the fibrinogen/C-reative protein is 0.791 which is higher than the 0.588 of the fibrinogen and the 0.331 of C-reactive protein.According to the JAAM score,the area under the curve of the ratio is 0.691 and higher than the 0.470 of fibrinogen and the 0.337 of C-reactive protein.Conclusions: In the DIC with sepsis,the plasma concentration of fibrinogen didn’t decline.And the percent of low plasma concentration of fibrinogen was 7.1%.The area of the ROC curve of fibrinogen/C-reactive protein ratio is higher than C-reactive protein ratio and fibrinogen.We suggest that the fibrinogen/C-reactive protein ratio can be a diagnostic factor for the DIC in sepsis.