Abstract:

Objective To investigate the significance of soluble CD14-subtype（sCD14-ST）in the early diagnosis of sepsis. Methods Prospective study was used. A total of 30 healthy controls and 50 patients with suspected sepsis were enrolled from March 2012 to August 2014. According to the guidelines of American College of Chest Physicians/Society of Critical Care Medicine（ACCP/SCCM）,the 50 patients were classified into sepsis group,bacterial infection of systemic inflammatory response syndrome（SIRS）group and local bacterial infection group. Plasma and/or serum were/was collected at the first medical evaluation before any medical treatment and after the use of antibiotics for 24 h and 72 h. The levels of sCD14-ST,procalcitonin（PCT）and C-reactive protein（CRP）were determined. Receiver operating characteristic（ROC）curve was used to evaluate the role of sCD14-ST in the early diagnosis of sepsis. Results sCD14-ST,PCT and CRP levels were higher in 3 patient groups than in control group at the first medical evaluation before any medical treatment（P<0.05）. There was statistical significance for sCD14-ST level among the 3 patient groups（P<0.05）. There was no statistical significance for PCT and CRP levels between bacterial infection of SIRS and sepsis groups（P>0.05）. The dynamic changes of sCD14-ST,PCT and CRP levels in sepsis group before and after treatment were analyzed. sCD14-ST level had statistical significance at the first medical evaluation before any medical treatment and after the use of antibiotics for 24 h and 72 h （P<0.05）. The areas under ROC curves were 0.956 for sCD14-ST,0.939 for PCT and 0.848 for CRP, respectively. Conclusions sCD14-ST is better than PCT and CRP in the diagnosis of sepsis,which can provide a reference for the early diagnosis of sepsis.

Key words: Soluble CD14-subtype, Procalcitonin, C-reactive protein, Sepsis