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| Study on predictive and evaluation value on prognosis and disease severity in septic patients by PCT CRP serum lactic acid APACHEⅡ and SOFA score |
| Zhang Yue-xin, Zhang Ling, Guo Xian-qing |
| Department of Emergency, Shaoxing People's Hospital, Zhejiang University Hospital, Shaoxing 312000, China |
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Abstract ObjectiveTo observe the expression of PCT, CRP, serum lactic acid, APACHE Ⅱ and SOFA score in septic patients with different stratification, and to explore their predictive and evaluation value on prognosis and disease severity. Methods: 82 septic patients, treated in emergency department of Shaoxing People's Hospital from September 2015 to December 2016, were enrolled retrospectively. The patients were divided into sepsis group (28 cases), severe sepsis group (30 cases) and septic shock group (24 cases) according to the stratification of disease severity, and also the 26 non-septic patients were enrolled as control group; Further, the patients were divided into survivor group and death group according to the prognosis. The vital sign, laboratory examination on admission including arterial blood gas, blood routine test, blood clotting, liver and kidney function, and serum lactic acid were recorded, and also the SOFA and APACHEⅡ score were calculated. The venous blood was also drawn, and the levels of plasma PCT and CRP were detected by ELISA and immunotubidimetry (ITM) respectively. The expression of CRP, PCT, serum lactic acid, SOFA and APACHEⅡ score were analyzed in septic patients with different stratification and prognosis; the correlation among CRP, PCT, serum lactic acid, SOFA and APACHEⅡ score were analyzed; and their early predictive value on prognosis (death) were analyzed by ROC analysis. Results: The levels of CRP, PCT, serum lactic acid, SOFA and APACHEⅡ score on admission in septic patients were higher than that of the control group (P＜0.05); except CRP, the expression of PCT, lactic acid, SOFA and APACHEⅡ score in septic shock patients were higher than that of the severe sepsis group (P＜0.05), and the expression of the parameters mentioned above were higher than that of the sepsis group (P＜0.05); the expression of CRP, PCT, lactic acid, SOFA and APACHEⅡ score on admission in the death group were obviously higher than that of the survivor group (P＜0.05); serum lactic acid was positive correlated with SOFA and APACHEⅡ score, with coefficient correlation of 0.346 and 0.368 (P＜0.05), and PCT was positive correlated with SOFA and APACHEⅡ score, with coefficient correlation of 0.646 and 0.728 (P＜0.05); the early predictive value of PCT and APACHEⅡ score on prognosis of septic patients, with AUC of 0.918 and 0.902, were higher than that of serum lactic acid, CRP and SOFA score, with AUC of 0.812, 0.748 and 0.682, respectively (P＜0.05). Conclusion: PCT, CRP, serum lactic acid, APACHEⅡ and SOFA score are benefit to evaluating disease severity of sepsis, and the early predictive value of prognosis by APACHEⅡ score and PCT are superior to serum lactic acid, CRP and SOFA score.
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Received: 28 July 2017
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| About author:: Zhang Yue-xin, E-mail：zhangyuexinyx@163.com |
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