The value of serum progranulin in the clinical diagnosis of adult sepsis patients / 中国医师进修杂志

ABSTRACT

Objective:To investigate the value of serum progranulin (PGRN)in the clinical diagnosis of adult sepsis patients.Methods:One hundred and eighty-seveninfection patients admitted to the intensive care unit(ICU) of Affiliated Dongfeng Hospital, Hubei University of Medicinewere divided into non-sepsis group(94 patients) and sepsis group (93 patients)according to the third international consensus definitions for sepsis and septic shock. Patients in the sepsis group were divided into two subgroups according to the degrees of infection: septic shock group (46 patients) and non-septic shock group (47 patients). The levels of serum PGRN, procalcitonin (PCT), C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α) and lactic acid (Lac) were compared between the two groups and subgroups within 1 h into the ICU, as well as the acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) and sequential organ failure assessment (SOFA) scores within 24 h into the ICU. Logistic regression model was used to analyze the relationship between PGRN and sepsis. The receiver operating characteristic (ROC) curve of the subject was drawn. The diagnostic value of PGRN in sepsis was evaluated and compared with PCT, CRP, IL-6, TNF-α and Lac.Results:The levels of PGRN, PCT, CRP, IL-6, TNF-α, Lac and APACHEⅡ, SOFA scores in the sepsis group were higher than those in the non-sepsis group: (129.25 ± 17.81) μg/L vs. (43.17 ± 7.68) μg/L, (5.92 ± 0.82) μg/L vs. (1.34 ± 0.17) μg/L, (64.07 ± 10.51) mg/L vs. (37.18 ± 5.44) mg/L, (111.68 ± 13.17) ng/L vs. (32.41 ± 5.61) ng/L, (86.06 ± 12.19) ng/L vs. (46.44 ± 7.63) ng/L, (2.96 ± 0.45) mmol/L vs. (1.47 ± 0.22) mmol/L, (23.62 ± 4.24) scores vs. (11.74 ± 2.07) scores, (14.84 ± 2.42) scores vs. (1.36 ± 0.23) scores, and the differences were statistically significant ( P<0.05). The levels of PGRN, PCT, CRP, IL-6, TNF-α, Lac in the septic shock group were higher than those in non-septic shock group:(143.29 ± 13.54) μg/L vs. (116.59 ± 10.73) μg/L, (7.64 ± 1.17) μg/L vs. (4.24 ± 0.59) μg/L, (74.49 ± 10.46) mg/L vs. (53.89 ± 8.41) mg/L, (124.48 ± 14.37) ng/L vs.(99.16 ± 13.61) ng/L, (95.91 ± 14.75) ng/L vs. (76.42 ± 11.24) ng/L, (3.52 ± 0.46) mmol/L vs. (2.45 ± 0.39) mmol/L, and the differences were statistically significant ( P<0.05). Logistic regression analysis showed that SODA scores and serum PGRN, PCT, CRP, IL-6, Lac levels were independent risk factors for sepsis ( P<0.05). The ROC curve analysis showed that the area under the curve (AUC) of PGRN was higher than that of CRP, IL-6, TNF-α and Lac for predicting the occurrence of sepsis in infection patients ( P<0.05). The AUC of PGRN was higher than that of CRP, IL-6, TNF-α and Lac for predicting the occurrence of septic shock in infection patients ( P<0.05). Conclusions:The levels of serum PGRN is a good biomarker for the diagnosis of sepsis and could reflect the severity. It has certain clinical value.