Values of procalcitonin and coagulation indicators in prognosis of severe acute respiratory distress syndrome

doi:10.3877/cma.j.issn.2095-9133.2020.05.003

Abstract

Abstract:

Objective

To investigate the prognostic value of serum procalcitonin (PCT) and coagulation parameters in patients with acute respiratory distress syndrome (ARDS).

Methods

From January 2016 to December 2019, 60 ARDS patients in Intensive Care Unit (ICU) of Changzhou Wujin Hospital of Traditional Chinese Medicine were selected for a retrospective clinical study. There were 34 males and 26 females, ranging in age from 34 to 75 years, with an average age of (55.8±11.2) years. According to the survival of patients at 30 days after admission, the subjects were divided into survival group (36 cases) and death group (24 cases). General data were collected and acute physiology and chronic health score (APACHE II) and lung injury score (Murray) were assessed. Venous blood was collected within 24 hours after the diagnosis of ARDS. Serum PCT level, prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (FIB) and D dimer (DD) were measured. Pearson correlation was used to analyze the correlation between serological test results and clinical scores. The working characteristic curve (ROC) of subjects was drawn to evaluate the predictive ability of the corresponding indicators for the survival of ARDS patients.

Results

Apache Ⅱ score [(26.8±3.1) in death group vs (22.3±2.6) score in survival group] and Murray score [(2.9±0.5 )in death group vs (2.2±0.3) in survival group) in death group were higher than those in survival group (P<0.05), serum PCT [(11.29±3.48) μg/L vs (4.37± 1.65)μg/L], Pt [(25.8±4.7±3.48) s vs. (16.4±3.1) s], APTT [(49.4±5.1) s vs. (32.9±2.5) s] and DD [(4.92±1.05) s vs. (3.52±0.74) s] in survival group were also higher than those in survival group, but FIB level in survival group was lower than that in survival group [(2.78±0.63) g/L vs. (4.26±0.91) g/L, P<0.05], but there was no significant difference in TT level between the two groups (P>0.05). Serum PCT, Pt, APTT and DD were positively correlated with Apache Ⅱ and Murray scores (P<0.05), while FIB was negatively correlated with clinical scores (P<0.05). The AUC of PCT combined with Pt, APTT, FIB and DD was 0.963, which was significantly higher than that of single index.

Conclusion

Serum PCT, PT, APTT, FIB and DD are closely related to the severity of lung injury in patients with ARDS, and PCT combined with coagulation indicators are of guiding significance in judging the condition and prognosis of patients with ARDS.

Key words: Procalcitonin, Acute Respiratory Distress Syndrome, Coagulation Index, Area under Curve

Hong Li, Hongying Jiang, Le Zhuang, Dan Zhou, Chenlin Lu. Values of procalcitonin and coagulation indicators in prognosis of severe acute respiratory distress syndrome[J]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2020, 06(05): 266-270.

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组别	例数	年龄(岁，±s)	BMI(kg/m²，±s)	性别		原发病因
组别	例数	年龄(岁，±s)	BMI(kg/m²，±s)	男性	女性	肺部感染	肺外感染	创伤	其他
生存组	36	55.4±10.7	23.1±2.5	20(55.6)	16(44.4)	14(38.9)	12(33.3)	6(16.7)	4(11.1)
死亡组	24	56.3±11.8	23.4±2.7	14(58.3)	10(41.7)	9(37.5)	8(33.3)	4(16.7)	3(12.5)
t/χ²值		2.52	1.84	2.69		2.37
P值		>0.05	>0.05	>0.05		>0.05

组别	例数	年龄(岁，±s)	BMI(kg/m²，±s)	性别		原发病因
组别	例数	年龄(岁，±s)	BMI(kg/m²，±s)	男性	女性	肺部感染	肺外感染	创伤	其他
生存组	36	55.4±10.7	23.1±2.5	20(55.6)	16(44.4)	14(38.9)	12(33.3)	6(16.7)	4(11.1)
死亡组	24	56.3±11.8	23.4±2.7	14(58.3)	10(41.7)	9(37.5)	8(33.3)	4(16.7)	3(12.5)
t/χ²值		2.52	1.84	2.69		2.37
P值		>0.05	>0.05	>0.05		>0.05

组别	例数	APACHEⅡ评分(分)	Murray评分(分)	PCT(μg/L)	PT(s)	APTT(s)	TT(s)	FIB(g/L)	DD(ng/L)
生存组	36	22.3±2.6	2.2±0.3	4.37±1.65	16.4±3.1	32.9±2.5	15.3±1.8	4.26±0.91	3.52±0.74
死亡组	24	26.8±3.1	2.9±0.5	11.29±3.48	25.8±4.7	49.4±5.1	16.5±1.9	2.78±0.63	4.92±1.05
t值		4.24	3.85	7.94	6.32	4.75	1.15	4.52	4.83
P值		<0.05	<0.05	<0.05	<0.05	<0.05	>0.05	<0.05	<0.05

组别	例数	APACHEⅡ评分(分)	Murray评分(分)	PCT(μg/L)	PT(s)	APTT(s)	TT(s)	FIB(g/L)	DD(ng/L)
生存组	36	22.3±2.6	2.2±0.3	4.37±1.65	16.4±3.1	32.9±2.5	15.3±1.8	4.26±0.91	3.52±0.74
死亡组	24	26.8±3.1	2.9±0.5	11.29±3.48	25.8±4.7	49.4±5.1	16.5±1.9	2.78±0.63	4.92±1.05
t值		4.24	3.85	7.94	6.32	4.75	1.15	4.52	4.83
P值		<0.05	<0.05	<0.05	<0.05	<0.05	>0.05	<0.05	<0.05

参数	PCT	PT	APTT	TT	FIB	DD
APACHEⅡ评分	0.623^a	0.394^a	0.521^a	0.102	-0.463^a	0.591^a
Murray评分	0.574^a	0.457^a	0.386^a	0.139	-0.352^a	0.649^a

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