Abstract：Objective To explore the application value of serum procalcitonin (PCT), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6) and the combined detection of three indicators in predicting the short-term risk of death in patients with sepsis. Methods The clinical data of 60 patients with sepsis admitted to the Department of emergency and critical care medicine of the Fourth Affiliated Hospital of Guangzhou Medical University from December 2019 to December 2021 were analyzed retrospectively. The general data of sepsis patients and laboratory serum indicators were analyzed, and the risk factors of sepsis patients' death were determined by logistic regression analysis, and the predictive ability of related indicators to death was evaluated by plotting the receiver operating characteristic (ROC) curve. Results Among the 60 patients with sepsis, 33 survived and 27 died within 28 days after admission; The age, serum PCT, hs CRP and IL-6 of the patients in the death group were significantly higher than those in the survival group (all P<0.05). Multivariate logistic regression analysis showed that PCT (OR=1.288), hs CRP (OR=1.195) and IL-6 (OR=1.184) were all independent factors of sepsis patients' death within 28 days (all P<0.05). The area under ROC curve (AUC) values of PCT, hs CRP, IL-6 and combined detection for the prognosis of sepsis patients were 0.843, 0.829, 0.726 and 0.938, respectively. The diagnostic efficiency of combined detection was significantly higher than that of other independent detection indicators (Z=3.791, 4.069, 5.271, P< 0.05), and the diagnostic accuracy of combined detection was the highest. Conclusion Serum PCT, hs CRP and IL-6 have certain predictive value for the risk assessment of death in sepsis patients, and the combined detection significantly improve the diagnostic efficiency of the risk of death in sepsis patients within 28 days.
刘长波, 陈锡娴, 宋永康, 索树珍, 罗丽娅, 黄河. 血清PCT、hs-CRP和IL-6联合检测对脓毒症患者短期死亡风险的预测价值[J]. 武警医学, 2022, 33(11): 968-971.
LIU Changbo, CHEN Xixian, SONG Yongkang, SUO Shuzhen, LUO Liya, HUANG He. Predictive value of combined detection of serum PCT, hs-CRP and IL-6 in the short-term risk of death in patients with sepsis. Med. J. Chin. Peop. Armed Poli. Forc., 2022, 33(11): 968-971.
Singer M,Deutschman C S,Seymour C W,et al.The third international consensus definitions for sepsis and septic shock (Sepsis-3) [J]. JAMA, 2016, 315(8): 801-810.
[2]
Rudd K E, Johnson S C, Agesa K M, et al. Global, regional, and national sepsis incidence and mortality, 1990-2017: analysis for the global burden of disease study[J]. Lancet, 2020, 395(10219): 200-211.
[3]
Rivers E, Nguyen B, Havstad S, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock[J]. New Eng J Med, 2001, 345(19): 1368-1377.
Liu C, Jin P, Luo Y, et al. Association of single-nucleotide polymorphisms of C-reactive protein gene with susceptibility to infantile sepsis in Southern China[J].Med Sci Monit, 2018, 30(24): 590-595.
[6]
Li S, Rong H, Guo Q, et al. Serum procalcitonin levels distinguish gram-negative bacterial sepsis from gram-positive bacterial and fungal sepsis[J]. J Res Med Sci, 2016, 21(1):39-51.
Sheth M, Benedum C M, Celi L A, et al. The association between autoimmune disease and 30-day mortality among sepsis ICU patients: a cohort study[J]. Crit Care, 2019, 23(1): 1-11.
[9]
Liu Y, Zhao W, Chen W, et al. Effects of early enteral nutrition on immune function and prognosis of patients with sepsis on mechanical ventilation[J]. J Intensive Care Med, 2020, 35(10): 1053-1061.
[10]
Martin L I, Guia M C, Vallecoccia M S, et al. Risk factors for mortality in elderly and very elderly critically ill patients with sepsis: a prospective, observational, multicenter cohort study[J]. Ann Intensive care, 2019, 9(1): 1-9.
[11]
Pierrakos C, Velissaris D, Bisdorff M, et al. Biomarkers of sepsis: time for a reappraisal[J]. Crit Care, 2020, 24(1): 1-15.
[12]
Sandquist M, Wong H R. Biomarkers of sepsis and their potential value in diagnosis, prognosis and treatment[J]. Expert Rev Clin Immunol. 2014, 10(10):1349-1356.
Kumar N, Dayal R, Singh P, et al. A Comparative Evaluation of Presepsin with Procalcitonin and CRP in Diagnosing Neonatal Sepsis[J]. Indian J Pediatr. 2019, 86(2):177-179.
[15]
Lorente L, Martín M M, Pérez C A, et al. Association between interleukin-6 promoter polymorphism (-174 g/c), serum interleukin-6 levels and mortality in severe septic patients[J]. Int J Mol Sci,2016, 17(11):1861.
[16]
Oda S, Hirasawa H, Shiga H, et al. Sequential measurement of IL-6 blood levels in patients with systemic inflammatory response syndrome (SIRS)/sepsis[J]. Cytokine, 2005, 29(4): 169-175.
Cui N, Zhang H, Chen Z, et al. Prognostic significance of PCT and CRP evaluation for adult ICU patients with sepsis and septic shock: retrospective analysis of 59 cases[J]. J Int Med Res, 2019, 47(4): 1573-1579.
2022, Vol. 33 
