Clin Lab. 2023 Mar 1;69(3). doi: 10.7754/Clin.Lab.2022.220613.
The goal was to investigate the prognostic value of serum procalcitonin (PCT), procalcitonin clearance (PCTc), and procalcitonin/albumin (PCT/ALB) in patients with sepsis.
We conducted a retrospective study on 128 adult patients with sepsis in the Department of Intensive Care Unit (ICU) and in the Department Infectious Disease in the Affiliated Cancer Hospital of Zhengzhou University. We observed PCT, ALB, arterial blood gas analysis (ABGs) and other main indicators of patients within 5 days after admittance from June 2020 to June 2021. The acute physiological function and chronic health status system II (APACHE II) scores, sepsis related organ failure assessment (SOFA) scores, procalcitonin clearance and PCT/ALB ratio were calculated, respectively. SPSS 22.0 and Graph pad 6.0 statistical software were used for statistical analysis.
The septic shock group had higher PCT, lower ALB, higher PCT/ALB ratio and higher APACHE II score than the sepsis group (p = 0.01733, p = 0.0142, p = 0.0030, p = 0.0061, respectively). The 28 day mortality group had lower ALB value, higher PCT/ALB ratio and higher APACHE II score than the survival group (p = 0.0105, p = 0.0345, p = 0.0152, respectively). The PCTc-day3 and PCTc-day5 were both significantly higher in patients who survived than in the 28 day mortality group (p = 0.0159, p = 0.0042, respectively). The AUC of PCT/ ALB for predicted the septic shock was 0.8966 (95% CI: 0.8370 to 0.9562, p < 0.0001), and the cutoff value, sensitivity and specificity was 0.87, 81.25%, and 85.19%, respectively. The AUC of PCT/ALB for the predicted 28 day mortality was 0.8353 (95% CI: 0.7534 to 0.9171, p < 0.0001), and the cutoff value, sensitivity and specificity was 0.83, 70.83% and 92.59%, respectively.
The PCT/ALB ratio was an important indicator for predicting septic shock and 28 day mortality in sepsis patients compared to PCT or ALB alone.
本研究旨在探讨血清降钙素原（PCT）、降钙素原清除率（PCTc）和降钙素原/白蛋白（PCT/ALB）比值对脓毒症患者预后的预测价值。
回顾性分析 2020 年 6 月至 2021 年 6 月郑州大学附属肿瘤医院重症监护病房（ICU）和感染科收治的 128 例脓毒症成年患者的临床资料，观察患者入院后 5 天内的 PCT、ALB、动脉血气分析（ABGs）等主要指标，计算急性生理学与慢性健康状况系统Ⅱ评分（APACHE II）、脓毒症相关器官衰竭评估（SOFA）评分、降钙素原清除率及 PCT/ALB 比值。采用 SPSS 22.0 和 Graph pad 6.0 统计软件进行统计分析。
与脓毒症组相比，脓毒症休克组 PCT 较高，ALB 较低，PCT/ALB 比值和 APACHE II 评分较高（p = 0.01733，p = 0.0142，p = 0.0030，p = 0.0061）。28 天病死率组 ALB 值较低，PCT/ALB 比值和 APACHE II 评分较高（p = 0.0105，p = 0.0345，p = 0.0152）。与 28 天病死率组相比，存活组 PCTc-day3 和 PCTc-day5 均明显升高（p = 0.0159，p = 0.0042）。PCT/ALB 预测脓毒症休克的 AUC 为 0.8966（95%CI：0.8370 至 0.9562，p < 0.0001），截断值、敏感度和特异度分别为 0.87、81.25%和 85.19%。PCT/ALB 预测 28 天病死率的 AUC 为 0.8353（95%CI：0.7534 至 0.9171，p < 0.0001），截断值、敏感度和特异度分别为 0.83、70.83%和 92.59%。
与单独使用 PCT 或 ALB 相比，PCT/ALB 比值是预测脓毒症患者脓毒症休克和 28 天病死率的重要指标。
