Abstract
Objective To evaluate the clinical value of serum procalcitonin (PCT) combined detection in assessment of patients with sepsis .Methods A total of 151 cases of children with sepsis admitted in Haining Traditional Chinese Medicine Hospital from March 2015 to March 2017 were selected and divided into group A (90 cases) and group B (61 cases) according to pathogenetic degree . Patients in group A had sepsis ,and patients in group B suffered from severe sepsis .PCT and relevant cardiac markers were analyzed in two groups .Results There were no significant differences in white blood cells and c-reactive protein levels between two groups (both P > 0 .05) .Heart rate and respiratory rate in group B were (163 .23 ± 33 .29) times/min and (46 .49 ± 11 .32) times/min ,respectively ,which were significantly higher than those in group A [(150 .23 ± 28 .38) times/min ,(40 .28 ± 10 .34) times/min] (t value was 2 .394 and 3 .485 ,respectively ,both P < 0 .05) .Systolic and diastolic blood pressure in group B were (89 .88 ± 22 .34) mmHg and (54 .43 ± 14 .33) mmHg ,respectively ,and both were significantly lower than those in group A [(99 .38 ± 15 .53) mmHg ,(60 .93 ± 13 .23) mmHg] (t value was 2 .752 and 2 .794 respectively ,both P < 0 .05) .Sensitive troponin ,N-terminal pro-brain natriuretic peptide ,creatine kinase isoenzyme and PCT levels in group B were significantly higher than those in group A (Z value was 3 .485 ,3 .485 ,6 .485 and 6 .485 ,respectively ,all P < 0 .05) .Eight cases died in group A and fatality rate was 13 .33% , while in group B 20 cases died and fatality rate was 32 .79% .Difference in two groups was statistically significant (χ2 = 12 .384 ,P < 0 .05) .Sensitive troponin ,N-terminal pro-brain natriuretic peptide ,creatine kinase isoenzyme and PCT levels in death cases were significantly higher than those in survival cases (Z value was 2 .384 ,4 .563 ,3 .482 and 4 .394 ,respectively ,all P < 0 .05) . There were no significant differences in white blood cell and c-reactive protein levels between death and survival cases (both P >0 .05) .Assessing values of sensitive troponin ,creatine kinase isoenzyme ,PCT and N-terminal pro-brain natriuretic peptide for children with sepsis increased in turn (AUC value was 0 .714 ,0 .822 ,0 .841 and 0 .856 , respectively ) .Assessing values of transaminase ,urea nitrogen ,creatinine ,alanine aminotransferase ,lactic acid ,blood glucose ,and pH level for children with sepsis were reduced in turn (AUC value was 0 .766 ,0 .734 ,0 .729 ,0 .721 ,0 .622 ,0 .572 and 0 .382 ,respectively ) .PCT ,creatine kinase isoenzyme ,N-terminal pro-brain natriuretic peptide ,sensitive troponin had good value in predicting prognosis of sepsis patients , and their areas under ROC curve were 0 .759 ,0 .721 ,0 .782 and 0 .611 ,respectively .For value of transaminase ,urea nitrogen , creatinine ,alanine aminotransferase ,lactic acid ,blood sugar ,pH levels in assessing prognosis of sepsis patients ,area under ROC curve of every indicator was 0 .642 ,0 .631 ,0 .702 ,0 .641 ,0 .672 ,0 .452 and 0 .381 ,respectively .Conclusion Cardiac dysfunction and myocardial injury are closely related with pathogenetic degree of sepsis .Sensitive troponin , N-terminal pro-brain natriuretic peptide ,creatine kinase isoenzyme and PCT levels can be used in diagnosis of sepsis ,and combined detection of four indicators is better than single index detection .关键词
脓毒症/儿童/心脏/降钙素原/标志物Key words
sepsis/children/heart/procalcitonin/marker分类
医药卫生
