Abstract:

Objective To investigate the changes of procalcitonin（PCT） and coagulation function indicators in children with sepsis and their correlation. Methods A total of 157 children with sepsis and 132 children without sepsis admitted to Shanghai Children's Medical Center from June 2021 to June 2022 were enrolled. Relevant basic information，primary disease，the incidence of disseminated or diffuse intravascular coagulation（DIC），the incidence of shock，sequential organ failure assessment（SOFA） score，the 28-day treatment outcomes of patients were recorded. PCT and coagulation function indicators [prothrombin time（PT），activated partial thromboplastin time（APTT），fibrinogen（Fib），D-dimer（DD）] were determined. According to the levels of PCT，the sepsis group was classified into 3 groups，including Group A（PCT<2.00 ng·mL^-1），Group B（2.00 ng·mL^-1≤ PCT <10.00 ng·mL^-1） and Group C（PCT≥10.00 ng·mL^-1）. The differences of each indicator between the 3 groups of sepsis group and non-sepsis group were compared，and the correlation between different PCT levels and coagulation function indicators in sepsis group was analyzed. Receiver operating characteristic（ROC） curve was used to evaluate the efficiency of each indicator for the poor prognosis of children with sepsis. Results PT and APTT were prolonged in sepsis group，which had statistical significance with those in non-sepsis group（P<0.05）. In sepsis group，the levels of PCT，Fib and DD were higher than those in non-sepsis group（P<0.05）. The levels of PT，APTT，Fib and DD in Group A，Group B and Group C were gradually increased. The higher the PCT and the more severe sepsis were in Group A，B and C，the more patients with poor prognosis. In sepsis group，PT，APTT, Fib and DD were positively correlated with PCT level（r=0.220、0.502、0.186 and 0.166，P<0.05）. The areas under curves of PCT，PT，APTT，Fib and DD were 0.822，0.819，0.524，0.541 and 0.879，respectively. The area under curve of PCT combined with PT，APTT，Fib and DD was 0.909，which had good sensitivity（89.5%） and specificity（78.9%）. Conclusions There is a correlation between PT，APTT，Fib，DD and PCT in children with sepsis. The efficiency of dynamic combined monitoring of PCT and coagulation function indicators for the diagnosis and prognosis of sepsis is better than that of single indicator，which can provide a reference for the determination and prognosis of clinical diagnosis and treatment plan for children with sepsis.

Key words: Procalcitonin, Coagulation function, Sepsis, Children