Procalcitonin: a new parameter for the prediction and assisting diagnosis of infection complications in severe multiple trauma patients / 第三军医大学学报

ABSTRACT

Objective To study the changes in tumor necrosis alpha(TNF ?), interleukin 6(IL 6), procalcitonin(PCT) and C reactive protein (CRP) levels and their values in the prediction and assisting diagnosis of infection complications in severe multiple trauma patients. Methods TNF ?, IL 6 and CRP were measured by enzyme linked immunosorbant assay(ELISA) and PCT was determined by immunoluminometric assay(ILMA) in serial samples of plasma from 34 patients with severe multiple trauma(ISS≥16) and compared with those of 11 normal control volunteers. Patients were divided into 2 groups(infection and non infection groups). The differences of the above parameters between groups were compared. In addition, all data were managed by receiver operating characteristic(ROC), and sensitivity, specificity, negative and positive predictive values for the diagnosis of infection complications were calculated. Results Plasma levels of TNF ?, IL 6, PCT and CRP in multiple trauma patients without infection complications were increased differently in the early posttrauma period. TNF ? and CRP levels in the early posttrauma period before infection were not significantly different from those in patients without infection complications, but they increased significantly following infection. However, during the whole observing period, plasma levels of PCT and IL 6 in the patients with infection complications were higher than those in patients without. The value of those parameters in assisting diagnosis of infection was evaluated. PCT was of the highest specificity and higher negative and positive predictive values. Conclusion All the parameters are of clinical value in infection diagnosis after severe multiple trauma. PCT is the best index for the prediction and assisting diagnosis of infection after multiple trauma.