HIGH LEVELS OF CRP, PCT AND HBP ARE COLLRELATED WITH PNEUMONIA SECONDARY SEPSIS

Ying Li^{1, #}, Ke Feng^{1, #}, Wei Chen^{1, #}, Jing Qiao^{2, #}, Meng Zhao^{3, *}

¹Department of Emergency, General Hospital of Ningxia Medical University, Yinchuan, PR China - ²Ningxia Hospital of CAPF, Yinchuan, PR China - ³Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China

Objective: To investigate the value of procalcitonin (PCT), high-sensitivity C-reactive protein (hsCRP) and heparin-binding protein (HBP) in predicting sepsis secondary to pneumonia. 

Methods: In total, 49 pneumonia patients treated in our hospital between April 2018 and March 2019 were randomly selected as the pneumonia group, and 35 patients with sepsis secondary to pneumonia were selected as the secondary sepsis group. At the same time, 45 healthy subjects who came to hospital for examination were selected as the normal group. The levels of blood lipids (serum total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL)) were measured by an automatic biochemical analyser. The acute physiological and chronic health status scores (APACHE Ⅱ) were compared. PCT levels were measured by fluorescence immunoquantitative analysis, hsCRP levels were measured by immunoturbidimetry, and HBP levels were measured by enzyme-linked immunosorbent assay (ELISA). A Cox regression curve model was established to analyse the independent risk factors of sepsis secondary to pneumonia. ROC curves were used to assess the value of the combined detection of CRP, PCT and HBP or single factor detection in predicting sepsis secondary to pneumonia. 

Results: There was no significant difference in the basic data and blood lipid indexes among the three groups. The APACHE Ⅱ scores in the pneumonia group and secondary sepsis group were significantly higher than those in the normal group (P<0.05). Compared with the normal group, the levels of serum PCT, hsCRP and HBP in the pneumonia group and secondary sepsis group were significantly higher (P<0.05), and the levels of PCT, hsCRP and HBP in the secondary sepsis group were significantly higher than those in the pneumonia group (P<0.05). The levels of serum PCT, hsCRP and HBP were independent risk factors for sepsis secondary to pneumonia. The ROC curve model showed that the areas under the curve of PCT, hsCRP, HBP and PCT + hsCRP + HBP were 0.876, 0.765, 0.921 and 0.969, respectively. The above indexes were beneficial in predicting sepsis secondary to pneumonia, and the predictive value of the three indexes in predicting secondary sepsis was significantly higher than that of single-factor detection. 

Conclusion: The levels of CRP, PCT and HBP in patients with sepsis secondary to pneumonia are significantly higher than those in healthy subjects. The above indexes can be used in the diagnosis of sepsis secondary to pneumonia, and the combined prediction value of these three indexes is higher.