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Introduction: Sepsis has a death rate of ?25% globally and its clinical treatment presents an important clinical challenge. The Acute Physiology and Chronic Health Evaluation II (APACHE II) is the standard method for assessing sepsis. Serum PCT level can be increase in case of sepsis. With this background, the present research is aimed to study the survival among the sepsis cases and correlate them with serum procalcitonin levels, APACHE II Score and other risk factors. Methodology: The study was conducted among 75 cases diagnosed having sepsis admitted in medical ICU. APACHE II score, serum procalcitonin (PCT) and other investigation were carried out along with clinical history and examination. Data were analysed using epi-info software. Results: The cases fatality rate of sepsis cases in medical intensive care unit in our hospital was 37.3%. The mortality rate was significantly higher patients with comorbidities, especially cases with respiratory or CNS involvement. The serum PCT levels were significantly higher in the group of non survivors as compared to group of survivors. Higher APACHE II score associated with higher mortality. Serum PCT levels go on increasing along the spectrum of sepsis. A PCT level was significantly hire in culture positive cases compare to sterile cases. Conclusion: From this study we conclude that serum PCT level is useful investigation in sepsis cases to predict mortality
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Objective:To investigate the changes in myocardial enzyme spectrum, procalcitonin, and C-reactive protein levels in neonates with hyperbilirubinemia.Methods:A total of 150 neonates with hyperbilirubinemia who received treatment in the 1 st Affiliated Hospital of Wenzhou Medical University during January-December 2019 were included in this study. They were allocated to mild (total bilirubin level 221-256.5 μmol/L, n = 68) and moderate-to-severe hyperbilirubinemia (total bilirubin level > 256.5 μmol/L, n = 82) groups according to different serum total bilirubin levels. An additional 70 healthy neonates who were born concurrently served as controls. Myocardial enzyme spectrum (creatine kinase, creatine kinase-MB, lactate dehydrogenase, alpha-hydroxybutyrate dehydrogenase), procalcitonin, and C-reactive protein levels were compared among groups. The correlation between myocardial enzyme spectrum, procalcitonin, and C-reactive protein levels and the severity of hyperbilirubinemia was investigated. The factors related to hyperbilirubinemia in neonates were analyzed using logistic regression analysis. Results:Serum levels of creatine kinase, creatine kinase-MB, lactate dehydrogenase, and alpha-hydroxybutyrate dehydrogenase were (1130.23 ± 385.42) U/L, (194.82 ± 60.33) U/L, (993.45 ± 271.46) U/L, and (493.76 ± 105.65) U/L, respectively in the moderate-to-severe hyperbilirubinemia group, which were significantly higher than those in the mild hyperbilirubinemia and control groups [(682.23 ± 258.53) U/L, (82.67 ± 24.43) U/L, (486.38 ± 112.57) U/L, (252.63 ± 38.73) U/L; (368.13 ± 104.20) U/L, (27.90 ± 8.29) U/L, (402.13 ± 102.20) U/L, (228.53 ± 34.30) U/L; F = 67.12, 56.23, 66.57, 44.34, all P < 0.01]. Serum levels of creatine kinase, creatine kinase-MB, lactate dehydrogenase, and alpha-hydroxybutyrate dehydrogenase were significantly higher in the mild hyperbilirubinemia group than those in the control group (all P < 0.05). Premature infants, intrauterine distress, neonatal asphyxia, amniotic fluid pollution, sepsis, omphalitis, erythrocyte glucose-6-phosphate dehydrogenase defect, and delayed passage of meconium are the risk factors for neonatal hyperbilirubinemia ( OR = 6.13, 5.40, 5.29, 4.26, 7.79, 6.99, 5.79, 5.44, all P < 0.05). Breastfeeding is an independent protective factor for the development of neonatal hyperbilirubinemia ( OR = 5.87, P < 0.05). Conclusion:Myocardial enzyme, procalcitonin, and C-reactive protein levels increase in neonates with hyperbilirubinemia with the aggravation of the disease. Close monitoring of high-risk factors of neonatal hyperbilirubinemia (including preterm infants, intrauterine distress, neonatal asphyxia, amniotic fluid pollution, sepsis, omphalitis, erythrocyte glucose-6-phosphate dehydrogenase defect, and delayed passage of meconium) and strengthening perinatal health care and high-risk pregnancy management can reduce the incidence of pathological jaundice.
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Purpose:To investigate the clinical significance of serum procalcitonin (PCT) concentrations and related indicators of infection in the early diagnosis and prognosis of severe surgical patients with infection. Methods: This study included 77 critically ill patients taken from the Surgery Department to the Intensive Care unit between June 2015 and July 2017. Patients were divided into control, sepsis and septic shock groups, and their serum concentrations of PCT and related indicators of infection were compared. Results: PCT levels increased significantly from the control to the sepsis group and from the sepsis to the septic shock group (P<0.01 each). There were no significant differences in white blood cell (WBC) count, neutrophil percentage and body temperature among the groups (P>0.05). Receiver operating curve (ROC) analysis showed that the areas under the curve (AUC) for PCT, WBC count, neutrophil percentage and body temperature were 0.949, 0.657, 0.640 and 0.656, respectively. PCT, with 0.52 µg/L as the cut-off concentration, had the highest performance in the diagnosis of severe surgical sepsis, with a sensitivity of 96.1%, a specificity of 92.3% and a Youden index of 0.884. Conclusion: PCT concentration is diagnostic of infection in severe surgical patients, has high specificity in the early diagnosis of sepsis, and can reflect the severity of infection.
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Background: The clinical manifestations of sepsis are highly variable. The signs of both infection and organ dysfunction may be subtle, and thus the most recent international consensus guidelines provide a long list of warning signs of incipient sepsis. Lactic acid, which is a by-product of anaerobic metabolism, can be used as a marker of tissue hypoperfusion. It is being used widely. Procalcitonin has more recently been studied in children.Methods: Totally 60 Children admitted with Septic Shock in PICU between Ages 3 Months to 12 Years were assessed for Serum Lactate & Serum Procalcitonin levels. Evaluation of the biomarkers was done on individual and combinational basis using receiver operating characteristics curve.Results: Out of 60 children, male were 40, female were 20 children. In stage-1 serum lactate' level was 47.83 (mg/dl) sensitivity is about 35.63 and specificity was 63.82' off p-value <0.065**.In stage -2 serum procalcitonin was 49.62 (mg/dl) sensitivity is about 37.77 and specificity was 69.28' off p-value <0.549**.In stage -3 serum procalcitonin was 52.89 (mg/dl) sensitivity is about 41.63 and specificity was 73.89' off p-value <0.651**Conclusions: Early recognition of risk factors will help in timely appropriate therapy and thereby will help in reducing mortality and morbidity in pediatric septic shock. The results suggest that PCT is valid for auxiliary diagnosis of septic conditions in children and used as an indicator of the severity of patients.
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Objective To evaluate the diagnostic value of serum procalcitonin (PCT) and C-Reactive protein(CRP) in cirrhosis patients with spontaneous peritonitis(SBP). Methods 45 cirrhosis patients with SBP(cirrhosis, spontaneous peritonitis group) and 52 cirrhosis patients without SBP(cirrhosis, non peritonitis group) in the department of Gastroenterology, Anji people's Hospital from January 2010 to January 2015 were enrolled, the serum PCT levels of 2 groups were detected by immune luminescence, and the serum CRP levels of 2 groups were detected by latex enhanced turbidimetric immunoassay, then the differences between the two groups were compared. Results Compared with cirrhosis patients without SBP, the PCT and CRP level have significantly increased in cirrhosis patients with SBP, and the sensitivity and specificity of PCT were higher than CRP, also, PCT combined with CRP test was more sensitive and specific than tested alone. Conclusion PCT combined with CRP test have great sensitivity and specificity in the diagnosis of cirrhosis ascites patients with SBP, and can be considered as the early diagnostic indictors of SBP.
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Objective To evaluate the diagnostic value of serum procalcitonin (PCT) and C-Reactive protein(CRP) in cirrhosis patients with spontaneous peritonitis(SBP). Methods 45 cirrhosis patients with SBP(cirrhosis, spontaneous peritonitis group) and 52 cirrhosis patients without SBP(cirrhosis, non peritonitis group) in the department of Gastroenterology, Anji people's Hospital from January 2010 to January 2015 were enrolled, the serum PCT levels of 2 groups were detected by immune luminescence, and the serum CRP levels of 2 groups were detected by latex enhanced turbidimetric immunoassay, then the differences between the two groups were compared. Results Compared with cirrhosis patients without SBP, the PCT and CRP level have significantly increased in cirrhosis patients with SBP, and the sensitivity and specificity of PCT were higher than CRP, also, PCT combined with CRP test was more sensitive and specific than tested alone. Conclusion PCT combined with CRP test have great sensitivity and specificity in the diagnosis of cirrhosis ascites patients with SBP, and can be considered as the early diagnostic indictors of SBP.
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Objective To explore the guidance value of cerebrospinal fluid(CSF)and serum procalcitonin(PCT)in the ventricular catheter indwelling time of intracranial pressure monitoring(ICP).Methods Fifty-eight cases patients with moderate and severe craniocerebral trauma who were given ICP ventricular catheter and external ventricular drainage(EVD)were selected,5 ml CSF and 2 ml venous blood were collected at operation,1st,7th,14th d after operation.The change of CSF and serum PCT and WBC levels were compared among different time,the correlation among each indicators and diagnosis value for intracranial infection were analyzed.Results The level of CSF and serum PCT and WBC increased with the lengthen of ventricular catheter indwelling time(CSF PCT:(0.09±0.02)μg/L of operation,(1.17±0.25)μg/L of 14 d after the operation;CSF WBC:(24.33±12.75)×106/L of operation,(431.52±140.26)×106/L of 14 d after the operation;serum PCT:(0.16±0.05)μg/L of operation,(4.57±1.41)μg/L of 14 d after the operation;serum WBC:(4.14±0.46)×106/L of operation,(14.24±3.05)×106/L of 14 d after the operation;P＜0.05).The CSF PCT was positively correlated with CSF WBC and serum PCT(r=0.614,0.711,P＜0.05).The diagnostic sensitivity of CSF and serum PCT for prognosis of intracranial infection were 95.2％,81.0％,the specificity were 94.6％,78.4％,the specificity of CSF PCT was significantly higher than that of serum PCT(P=0.041).Conclusion CSF and serum PCT has high early diagnosis value for intracranial infection in patients with ICP ventricular catheter,which can contribute to guide the reasonable timing of tube drawing,brings out the best of ICP and cerebrospinal fluid drainage,improve the level of treatment in patients with traumatic brain injury.
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Objective:To investigate the application value of serum procalcitonin in patients with viral infection,bacterial infection and severe bacterial infection.Methods:Selected60 cases of patients with infection who were treated in our hospital from June 2014toDecember 2016,divided into three groupsaccording to the severity of the infection,viral infection (group A) 15 cases,general bacterial infection (group B) 22 cases,and severe bacterial infection (group C) 23 cases.Three groups of patients were treated with symptomatic treatment,and after admission,the serum procalciton in levels were detected in 1,3,5,7 d,and compared with the serum procalcitonin levels before and after treatment in the three groups.Results:The serum procalcitonin ≥ 0.5 μg/L number of B group and C group had no significant difference (P＞0.05),the serum procalcitonin ≥ 0.5 μg/L number of A group was significantly lower than that of B group and C group (P＜0.05);the survival rate of severe bacterial infection patients whose serum procalcitonin was higher than than 0.5 μg/L was significantly higher than those who with serum procalcitonin lower than 0.5 μg/L (P＜0.05).Conclusion:Serumprocalcitonin level had a good application value in the clinical diagnosis prognostic prediction of patients with severe infection.
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Objective To investigate the relationship between the levels of serum procalcitonin (PCT) and cardiac troponin I (cTnI) in patients with sepsis.Methods According to the severity of the disease, 126 patients with sepsis in the Department of Critical Care Medicine of Hubei Provincial Hospital of Integrated Chinese and Western Medicine from June 2013 to February 2015 were divided into three groups: sepsis, severe sepsis and septic shock groups, 42 cases in each group. The changes of lactate (Lac) and central venous oxygen saturation (ScvO2) were monitored in the three groups within 72 hours after admission, the mortality and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score within 24 hours after admission, the levels of serum PCT and cTnI were compared among the three groups, and the correlations between serum PCT, cTnI levels and APACHE Ⅱ score were analyzed.Results Along with the increase of patients' severity in the three groups, the levels of Lac (mmol/L) were gradually increased (prior treatment: 5.82±2.42, 7.97±3.76, 10.30±2.82; 6 hours after treatment: 3.63±1.54, 5.08±1.98, 7.50±1.35; 12 hours after treatment: 2.70±1.55, 4.13±1.96, 6.23±1.16; 24 hours after treatment: 2.58±1.35, 3.95±2.44, 5.25±1.13; 48 hours after treatment: 2.15±1.82, 3.86±2.36, 4.12±1.72; 72 hours after treatment: 1.83±1.04, 3.78±1.84, 3.74±0.87), while the levels of ScvO2 were gradually reduced (prior treatment: 0.556±0.102, 0.502±0.095, 0.402±0.092; 6 hours after treatment: 0.627±0.062, 0.557±0.083, 0.504±0.075; 12 hours after treatment: 0.658±0.076, 0.601±0.083, 0.595±0.072; 24 hours after treatment: 0.676±0.059, 0.625±0.084, 0.603±0.050; 48 hours after treatment: 0.704±0.049, 0.656±0.066, 0.615±0.035; 72 hours after treatment: 0.755±0.053, 0.707±0.066, 0.629±0.048). The higher the Lac, the lower the ScvO2, and the differences among the three groups were of statistical significance (allP < 0.01). The mortalities of patients in the septic, severe septic and septic shock groups were as follows: 11.9% (5/42), 21.4% (9/42), 38.1% (16/42); serum PCT (μg/L): prior treatment: 5.21±2.92, 17.20±4.81, 40.71±5.22; 4 days after treatment: 2.51±1.52, 10.72±3.83, 46.45±4.25; the levels of cTnI (μg/L): prior treatment: 5.31±0.82, 9.50±0.31, 15.12±3.15; 4 days after treatment: 1.16±0.62, 5.35±0.53, 9.24±1.25; APACHE Ⅱ score: prior treatment: 10.41±3.72, 20.15±5.14, 35.17±4.58; 4 days after treatment: 7.25±2.22, 14.15±4.16, 28.12±3.13. Their levels were also increased along with the increase of the septic severity. The correlation analyses showed that the serum levels of PCT was significantly positively correlated with cTnI and APACHE Ⅱ score (r value was respectively 0.922, 0.921, bothP < 0.01).Conclusion Myocardial damage often easily occurs in patients with sepsis, and the more serious the illness, the more prominent the injury.
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Objective To investigate the changes of immune function,serum procalcitonin (PCT) and C-reactive protein (CRP) in children with mycoplasma pneumoniae pneumonia (MPP),and to provide clinical evidence for immunotherapy in children with MPP.Methods A total of 126 children with MPP during their hospitalization were enrolled into lobar pneumonia group (n =42) and bronchopneumonia group (n =84),and 28 healthy children were enrolled into normal control group.The immunoglobulin(Ig),CD4+T,CD8+T,PCT and CRP of all children were determined.Results The levels of IgG,IgM and IgE of children in lobar pneumonia group and bronchopneumonia group were significantly higher than that of the normal control group (P ＜0.05),but there were no significant differences in the level of IgA between three groups (P ＞ 0.05).The levels of IgG in lobar pneumonia group were significantly higher than that of bronchopneumonia group (P ＜ 0.05),but there were no significant differences in the levels of IgM,IgE,IgA between the two groups(P ＞0.05).The ratios of CD4+T and CD4+T/CD8+T in lobar pneumonia group and bronchopneumonia group were significantly lower than that of the normal control group(P ＜ 0.05).The levels of PCT and CRP in lobar pneumonia group and bronchopneumonia group were significantly higher than that of the normal control group (P ＜ 0.05).Conclusion Humoral immunity and cellular immune dysfunction plays an important role in pathogenesis of MPP.They are important for PCT and CRP in evaluating clinical condition and immunotherapy.
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Objective To evaluate the application of serum procalcitonin(PCT)eetection in patients with severe infection. Methods Seventy-six infectee patients in respiratory intensive care unit(RICU)of the First People′s Hospital of Shangqiu were selectee as our subjects. Patients were eivieee into A group(28 cases of general bacterial infection),B group(36 cases of severe bacterial infection ),C group(12 cases of viral infection). Serum PCT was eetectee at the 1st,3re,5th,7th,9th eays after hospitalization. Results PCT concentration in A,B,C groups were((2. 7 ± 0. 8),(18. 9 ± 5),(0. 6 ± 0. 2))μg/ L respectively,ane there was significant eifference between 3 groups(F = 213. 73,P = 0. 000). The PCT level in B group was higher than of A group,ane PCT in A group was higher than in C group( all P < 0. 05). In B group,PCT concentration at 1st,3re,5th,7th,9th eays after treatment were((18. 9 ± 5),(18. 3 ± 5. 7),(16. 4 ± 5. 5), (12. 2 ± 4. 1),(8. 5 ± 2. 8),(6 ± 2. 1))μg/ L. In A group,PCT concentration at before treatment,1st,3re,5th, 7th,9th eays after treatment were((2. 7 ± 0. 8),(2. 6 ± 0. 7),(2. 3 ± 0. 8),(1. 7 ± 0. 6),(1. 3 ± 0. 5),(0. 9 ± 0. 3))μg/ L respectively. There were significant eifferent between two groups(F between group = 626. 07,F inner group = 75. 21,F interaction = 43. 36,P < 0. 01). After 5 eay antibiotic treatment in two group,PCT concentration at post-treatment were significantly eecreasee comparee with pre-treatment( P < 0. 01). Conclusion The eetection of serum PCT is valuable for eiagnosis ane evaluation of the eegree of clinical bacterial infection. PCT monitor can be usee to evaluate the therapeutic effect,ane assist the clinician to juege the prognosis.
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Objective To explore the clinical applications of the PCT and hs-CRP in inflammatory diseases.Methods The sera of 79 infectious patients were randomly collected.54 samples were bacterial infectious patients,25 samples were nonbacterial infectious patients.The serum levels of PCT and hsCRP in 79 infectious cases were detected by immune fluorescence and Immunoturbidimetry respectively.Results The positive rate of PCT in bacterial infectious patients were much higher than that in nonbacterial infectious patients (x2 =48.337,P ＜ 0.01),and the sensitivity was 92.5％,the specificity was 88.0％ ;The positive rate of hs-CRP in bacterial infectious patients were much higher than that in nonbacterial infectious patients (x2 =22.347,P ＜ 0.01),and the specificity was 88.9％,the specificity was 56.0％.The positive predictive value (88.9％) and negative predictive value (70.0％) of hs-CRP were lower than those of PCT (positive predictive values of 94.3％ and negative predictive value of 84.6％).Conclusion Theserum levels of PCT in inflammatory diseases were significantly increased with an high sensitivity and high specificity.Thus,it may be used as a new marker of inflammatory,which can be helpful in the early evaluation of infectious disease and the observation of curative efficacy.
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BACKGROUND/AIMS: The bedside index of severity in acute pancreatitis (BISAP) is a new, convenient, prognostic multifactorial scoring system. As more data are needed before clinical application, we compared BISAP, the serum procalcitonin (PCT), and other multifactorial scoring systems simultaneously. METHODS: Fifty consecutive acute pancreatitis patients were enrolled prospectively. Blood samples were obtained at admission and after 48 hours and imaging studies were performed within 48 hours of admission. The BISAP score was compared with the serum PCT, Ranson's score, and the acute physiology and chronic health examination (APACHE)-II, Glasgow, and Balthazar computed tomography severity index (BCTSI) scores. Acute pancreatitis was graded using the Atlanta criteria. The predictive accuracy of the scoring systems was measured using the area under the receiver-operating curve (AUC). RESULTS: The accuracy of BISAP (> or = 2) at predicting severe acute pancreatitis was 84% and was superior to the serum PCT (> or = 3.29 ng/mL, 76%) which was similar to the APACHE-II score. The best cutoff value of BISAP was 2 (AUC, 0.873; 95% confidence interval, 0.770 to 0.976; p < 0.001). In logistic regression analysis, BISAP had greater statistical significance than serum PCT. CONCLUSIONS: BISAP is more accurate for predicting the severity of acute pancreatitis than the serum PCT, APACHE-II, Glasgow, and BCTSI scores.
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Female , Humans , Male , Middle Aged , Biomarkers/blood , Calcitonin/blood , Logistic Models , Pancreatitis/blood , Prognosis , Prospective Studies , Protein Precursors/blood , ROC Curve , Severity of Illness IndexABSTRACT
Objective To observe the efficacy of Shenling Baizhu powder combined with Erchentang in treatment of senile pneumonia, and its influence on serum procalcitonin. Methods With randomized controlled trial, 100 patients were randomly divided into two groups. The control group (49 cases) was treated by routine western medicine, and the treatment group (51 cases) was treated by Shenling Baizhu powder combined with Erchentang additionally. The treatment course was 1 week, and the therapeutic effect was observed after two courses. The improvement time of clinical symptoms and signs, and the change of serum procalcitonin were detected. Results Clinical efficacy of the two groups had no significant difference (P>0.05). The improvement time of signs and symptoms in treatment group was better than that in control group (P<0.05). The serum procalcitonin improved in treatment group was better than that in control group (P<0.05). Conclusion Shenling Baizhu powder combined with Erchentang has obvious anti-infection effect, and can improve symptoms and signs of senile pneumonia rapidly.
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BACKGROUND/AIMS: The aim of this study is to assess serum procalcitonin (PCT) for early prediction of severe acute pancreatitis compared with multiple scoring systems and biomarkers. METHODS: Forty-four patients with acute pancreatitis confirmed by radiological evidences, laboratory assessments, and clinical manifestation were prospectively enrolled. All blood samples and image studies were obtained within 24 hours of admission. RESULTS: Acute pancreatitis was graded as severe in 19 patients and mild in 25 patients according to the Atlanta criteria. Levels of serum PCT were significantly higher in severe acute pancreatitis (p=0.001). The accuracy of serum PCT as a predicting marker was 77.3%, which was similar to the acute physiology and chronic health examination (APACHE)-II score, worse than the Ranson score (93.2%) and better than the Balthazar CT index (65.9%). The most effective cut-off level of serum PCT was estimated at 1.77 ng/mL (AUC=0.797, 95% CI=0.658-0.935). In comparision to other simple biomarkers, serum PCT had more accurate value (77.3%) than C-reactive protein (68.2%), urea (75.0%) and lactic dehydrogenase (72.7%). Logistic regression analysis revealed that serum PCT has statistical significance in acute severe pancreatitis. Assessment of serum PCT levels and length of hospital stay by simple linear regression analysis revealed effective p-value with low R square level, which could make only possibilty for affection of serum PCT to admission duration (r2=0.127, p=0.021). CONCLUSIONS: Serum PCT was a promising simple biomarker and had similar accuracy of APACHE-II scores as predicting severity of acute pancreatitis.