Predictive value of the serum amyloid A, heparin-binding protein, and procalcitonin in patients with biliary infection complicated with sepsis

ObjectiveTo explore the predictive value of the serum amyloid A(SAA), heparin-binding protein(HBP), and procalcitonin(PCT) in patients with biliary tract infection complicated with sepsis.

MethodsA total of 117 patients from the emergency surgery department were divided into the biliary tract infection complicated without sepsis group(non-sepsis group, 35 cases) and biliary tract infection complicated with sepsis group(sepsis group, 82 cases) according to the diagnostic criteria of sepsis, and the sepsis group was divided into the common sepsis group(common group, 55 cases) and septic shock group(shock group, 27 cases) according to the presence or absence of shock.The serum SAA, HBP, PCT, WBC, Acute Physiological and Chronic Health Assessment(APACHE Ⅱ) score and Sequential organ failure Estimate(SOFA) score were observed within 24h after admission.Another 40 healthy examination people during the same period were selected as the control group.The correlation indexes of each group were compared, and the diagnostic efficiency of each index in biliary tract infection complicated with sepsis was evaluated by ROC curve analysis.

ResultsThe serum levels of HBP, PCT and SAA in the non-sepsis group, general group and shock group were higher than those in control group (P < 0.05).The serum HBP, PCT and SAA levels in the non-sepsis group, general group and shock group increased successively(P < 0.05).There was no statistical significance in the WBC among all groups(P>0.05).The levels of HBP, PCT and SAA were positively correlated with APACHEⅡ score and SOFA score(P < 0.01).According to the follow-up results, the sepsis group was divided into the survival group(65 cases) and death group(17 cases) according to whether the patients survived at 28 days.The HBP, PCT, SAA levels and APACHE Ⅱ and SOFA scores in the death group were significantly higher than those in survival group (P < 0.01).The results of logistic regression analysis showed that high levels of HBP, PCT and SAA were the independent risk factors of survival outcome of sepsis patients (P < 0.05).The results of ROC curve analysis showed that the HBP and HBP+PCT had higher sensitivity in diagnosing biliary tract infection complicated with sepsis, and the HBP+SAA had higher specificity.

ConclusionsThe SAA, HBP and PCT have certain auxiliary diagnostic value in biliary tract infection progression to sepsis, the HBP has a high sensitivity, while the combined detection of HBP and SAA has a high specificity.