A study on the correlation between serum procalcitonin and cardiac troponin I levels in patients with sepsis / 中国中西医结合急救杂志

ABSTRACT

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.