ABSTRACT
Objective To evaluate the value of procalcitonin(PCT) and endotoxin(ET) in early diagnosis and prognosis in critically illness patients with sepsis.Methods A total of 104 cases with suspected sepsis were prospectively collected in this study from February 2015 to October 2016 in ICU.There were 31 cases of systemic inflammatory response syndrome (SIRS group),30 cases of sepsis 24 cases of severe sepsis and 19 cases of septic shock.Prognosis was observed in patients with sepsis discharged,57 cases were survival (survival group) while 16 cases were dead (death group).The level of PCT and ET and the clinical characteristics were recorded,The the ROC curve was applied to evaluate the discriminative power of variables.Results The levels of PCT,APACHE-Ⅱ score,ET of cases with sepsis,severe sepsis and septic shock were significantly higher than those in SIRS group(P0.05).ROC curve showed that AUC of PCT was 0.867,which was significantly higher than that for APACHE-Ⅱ score (AUC=0.762) (P>0.05).Conclusion Compared with APACHE-Ⅱ score and ET,PCT can help clinicians to early diagnose and treat cases with sepsis.
ABSTRACT
Objective To use thrombelastography (TEG) and conventional coagulation tests (CCTs) to diagnose disseminated intravascular coagulation (DIC) and find a better diagnostic method.Methods Patients with potential DIC factors,DIC clinical manifestation or DIC patients suspected by laboratory tests were included after their admission into our hospital.TEGs and CCTs were detected,respectively.DIC score was evaluated.The single factor logistic regression was used to evaluate the correlation between TEG and CCTs as well as the diagnostic accuracy.Results The international normalized ratio (INR) in CCTs of the DIC patients were significantly higher,the reaction rime (R),clot formation time (K),angle rate of clot formation (α),maximum amplitude (MA),and composite index (CI) figures in TEG were significantly increased (P ＜ 0.05).The sensitivity and specificity of TEG were 82.4％,and 62.2％,which were significantly higher than 21.6％ and 47.2％ in CCTs (P ＜ 0.05).Single factor logistic regression results show that odd ratio (OR) in prothrombin time (PT) and INR of CCTs was 1.23 and 1.27,respectively.The OR in R,K,α,MA,and CI of TEG was 5.13,6.14,1.37,1.25,and 3.02,respectively.Conclusions Compared to CCTs,TEG is more indicative of the conditions of DIC patients and it might be a better way to predict the DIC risks,which is of greater value in clinical diagnosis.