Study on predictive and evaluation value on prognosis and disease severity in septic patients by PCT CRP serum lactic acid APACHE Ⅱ and SOFA score

Zhang Yue-xin; Zhang Ling; Guo Xian-qing

doi:10.3969/j.issn.1002-1949.2017.12.009

Abstract：Objective To observe the expression of PCT,CRP,serum lactic acid,APACHE Ⅱ and SOFA score in septic patients with different stratification,and to explore their predictive and evaluation value on prognosis and disease severity.Methods 82 septic patients,treated in emergency department of Shaoxing People's Hospital from September 2015 to December 2016,were enrolled retrospectively.The patients were divided into sepsis group (28 cases),severe sepsis group (30 cases) and septic shock group (24 cases) according to the stratification of disease severity,and also the 26 non-septic patients were enrolled as control group;Further,the patients were divided into survivor group and death group according to the prognosis.The vital sign,laboratory examination on admission including arterial blood gas,blood routine test,blood clotting,liver and kidney function,and serum lactic acid were recorded,and also the SOFA and APACHE Ⅱ score were calculated.The venous blood was also drawn,and the levels of plasma PCT and CRP were detected by ELISA and immunotubidimetry (ITM) respectively.The expression of CRP,PCT,serum lactic acid,SOFA and APACHE Ⅱ score were analyzed in septic patients with different stratification and prognosis;the correlation among CRP,PCT,serum lactic acid,SOFA and APACHE Ⅱ score were analyzed;and their early predictive value on prognosis (death) were analyzed by ROC analysis.Results The levels of CRP,PCT,serum lactic acid,SOFA and APACHE Ⅱ score on admission in septic patients were higher than that of the control group (P ＜0.05);except CRP,the expression of PCT,lactic acid,SOFA and APACHE Ⅱ score in septic shock patients were higher than that of the severe sepsis group (P ＜ 0.05),and the expression of the parameters mentioned above were higher than that of the sepsis group (P ＜ 0.05);the expression of CRP,PCT,lactic acid,SOFA and APACHE Ⅱ score on admission in the death group were obviously higher than that of the survivor group (P ＜ 0.05);serum lactic acid was positive correlated with SOFA and APACHE Ⅱ score,with coefficient correlation of 0.346 and 0.368 (P ＜ 0.05),and PCT was positive correlated with SOFA and APACHE Ⅱ score,with coefficient correlation of 0.646 and 0.728 (P ＜ 0.05);the early predictive value of PCT and APACHE Ⅱ score on prognosis of septic patients,with AUC of 0.918 and 0.902,were higher than that of serum lactic acid,CRP and SOFA score,with AUC of 0.812,0.748 and 0.682,respectively (P＜0.05).Conclusion PCT,CRP,serum lactic acid,APACHE Ⅱ and SOFA score are benefit to evaluating disease severity of sepsis,and the early predictive value of prognosis by APACHE Ⅱ score and PCT are superior to serum lactic acid,CRP and SOFA score.