Procalcitonin in Acute Pancreatitis and in Septic States
Kazda A. 1 , Brodská H. 2 , Valenta J. 3 , Uhrová I. 2 , Hendl J. 4 , Bělohlávek J. 5 , Stříteský M. 6
1 Katedra klinické biochemie, IPVZ, Praha 2 Ústav klinické biochemie, 1. LF UK, Praha 3 Klinika AR, 1. LF UK, Praha 4 Katedra kinantropologie, FTVS UK, Praha 5 IV. interní klinika, 1. LF UK, Praha 6 Kardiochirurgická klinika, 1. LF UK, Praha |
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Summary:
The aim of our work was focused on the investigation and evaluation of procalcitonin (PCT) and of C-reactive
protein (CRP) serum values as markers of defined clinical situations in intensive care patients.
Materials and methods: Two sets of patients were investigated. The first one included 14 patients with the
diagnosis of acute pancreatitis. 9 of them had mild acute pancreatitis, three necrotising pancreatitis without
septic shock and 2 with septic shock.
The second set was formed by 20 patients. In 3 of them SIRS was present, in 4 sepsis, in 7 severe sepsis and in
6 septic shock. In each patient 2 to 4 investigations of PCT and CRP were performed in time intervals of 3 to 5
days. The control group comprised 10 blood donors.
Results: In the above mentioned stages of acute pancreatitis, i.e., light acute, necrotising without shock and
with shock the PCT values were: 0.69 ± 0.50 mg/l, 1.27 ± 1.04 mg/l and 5.73 ± 1.76 mg/l. There were significant
differences between each given and preceding group. Also the difference between mild acute pancreatitis and
necrotising pancreatitis with shock was significant. The corresponding CRP values were: 103 ± 109 mmol/l, 264
± 167 mmol/l and 151 ± 73 mmol/l. Also for CRP the differences between the given and preceding group were
always significant. The surprising decrease in shocked patients may, of course, be influenced by the limited
number of investigations.
In groups of SIRS, sepsis, severe sepsis and septic shock the PCT values were as follows: 0.79 ± 0.30 mg/l, 1.09 ±
0.78 mg/l, 4.21 ± 25.97 mg/l and 130.14 ± 179.20 mg/l. The high values in shock were significantly different from values
in all other three groups. The corresponding CRP values were: 186 ± 38 mmol/l, 169 ± 131 mmol/l, 176 ± 79 mmol/l
and 252 ± 140 mmol/l. There was a significant difference between septic shock and sepsis as well as between septic
shock and severe sepsis, but not between septic shock and SIRS.
The PCT values in blood donors were: 0.48 ± 0.20 mg/l.
Conclusion: PCT presents a sensitive marker of the stage of disease in both investigated sets of patients. The
difference between the various stages of disease was more often significant for PCT than for CRP. So far the
number of our investigations is limited and we consider the presented results more as a report on continuing
work than conclusive results. In the discussion a survey of experience and knowledge with investigation and evaluation of PCT in clinical
practice is presented.
Key words:
acute pancreatitis, SIRS, sepsis, procalcitonin, C-reactive protein.
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