Application value of procalcitonin, C‑reactive protein and interleukin‑6 in the evaluation of traumatic shock

Li,Yang; Chen,Ling; Fang,Wenge; Chen,Huihong

doi:10.3892/etm.2019.7492

Application value of procalcitonin, C‑reactive protein and interleukin‑6 in the evaluation of traumatic shock

Authors:
- Yang Li
- Ling Chen
- Wenge Fang
- Huihong Chen
View Affiliations

Affiliations: Department of Emergency, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian 363000, P.R. China, Department of Emergency, Zhangzhou Municipal Hospital of Fujian Province, Zhangzhou, Fujian 363000, P.R. China
Published online on: April 16, 2019 https://doi.org/10.3892/etm.2019.7492
Pages: 4586-4592
Copyright: © Li et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Procalcitonin (PCT), C‑reactive protein (CRP) and interleukin‑6 (IL‑6) were detected to explore the value of these inflammatory markers in the assessment of traumatic shock patients. The clinical data of 80 patients with traumatic shock and infections in Zhangzhou Municipal Hospital of Fujian Province from January 2014 to December 2017 were collected as the experimental group. During the same period, 80 acute trauma patients who did not suffer from traumatic shock were regarded as the control group. According to the prognosis outcomes, the experimental group was divided into 56 patients with good prognosis and 24 patients with poor prognosis. Also the PCT, CRP and IL‑6 levels in serum of patients at admission (T1), 12 h after admission (T2), three days after admission (T3) and on day 7 (T4) were detected. The differences between the three inflammatory indicators, the pre‑admission injury severity score (ISS score), the acute physiology and chronic psychological score (APACHE II score) were compared between the good prognosis and the poor prognosis group. The serum CRP at the T4 time period was significantly lower than both the T1 and T2 time periods (P<0.05). There were differences in serum PCT, CRP and IL‑6 between the good prognosis and the poor prognosis group at the time of T1‑T4 (P<0.05). The expression levels of PCT, CRP and IL‑6 in the serum of patients with poor prognosis were higher than those with good prognosis (P<0.05). Pre‑admission ISS scores and APACHE II scores in patients with good prognosis were lower than those with poor prognosis (P<0.05). Detection of PCT, CRP and IL‑6 expression levels in serum of the patients has an important reference value for assessing the condition of patients with traumatic shock.

View Figures

View References

1	Benjet C, Bromet E, Karam EG, Kessler RC, McLaughlin KA, Ruscio AM, Shahly V, Stein DJ, Petukhova M, Hill E, et al: The epidemiology of traumatic event exposure worldwide: results from the World Mental Health Survey Consortium. Psychol Med. 46:327–343. 2016. View Article : Google Scholar : PubMed/NCBI
2	Kunitatsu K, Ueda K, Iwasaki Y, Yamazoe S, Yonemitsu T, Kawazoe Y, Kawashima S, Shibata N and Kato S: Outcomes of abdominal trauma patients with hemorrhagic shock requiring emergency laparotomy: efficacy of intra-aortic balloon occlusion. Acute Med Surg. 3:345–350. 2016. View Article : Google Scholar : PubMed/NCBI
3	Grote S, Böcker W, Mutschler W, Bouillon B and Lefering R: Diagnostic value of the Glasgow Coma Scale for traumatic brain injury in 18,002 patients with severe multiple injuries. J Neurotrauma. 28:527–534. 2011. View Article : Google Scholar : PubMed/NCBI
4	Yaroustovsky M, Rogalskaya E, Plyushch M, Klimovich L, Samsonova N and Abramyan M: The level of oxidative neutrophil response when determining endotoxin activity assay: a new biomarker for defining the indications and effectiveness of intensive care in patients with sepsis. Int J Inflam. 2017:34952932017. View Article : Google Scholar : PubMed/NCBI
5	Müller B, Christ-Crain M and Schuetz P: Meta-analysis of procalcitonin for sepsis detection. Lancet Infect Dis. 7:498–499; author reply 502–503. 2007. View Article : Google Scholar : PubMed/NCBI
6	Zurek J and Vavrina M: Procalcitonin biomarker kinetics to predict multiorgan dysfunction syndrome in children with sepsis and systemic inflammatory response syndrome. Iran J Pediatr. 25:e3242015.PubMed/NCBI
7	Harrison M: Erythrocyte sedimentation rate and C-reactive protein. Aust Prescr. 38:93–94. 2015. View Article : Google Scholar : PubMed/NCBI
8	Hunter CA and Jones SA: IL-6 as a keystone cytokine in health and disease. Nat Immunol. 16:448–457. 2015. View Article : Google Scholar : PubMed/NCBI
9	Máca J, Peteja M, Reimer P, Jor O, Šeděnková V, Panáčková L, Ihnát P, Burda M and Ševčík P: Surgical injury: comparing open surgery and laparoscopy by markers of tissue damage. Ther Clin Risk Manag. 14:999–1006. 2018. View Article : Google Scholar : PubMed/NCBI
10	Lou X, Lu G, Zhao M and Jin P: Preoperative fluid management in traumatic shock: a retrospective study for identifying optimal therapy of fluid resuscitation for aged patients. Medicine (Baltimore). 97:e99662018. View Article : Google Scholar : PubMed/NCBI
11	Nieboer P, van der Werf TS, Beentjes JA, Tulleken JE, Zijlstra JG and Ligtenberg JJ: Catecholamine dependency in a polytrauma patient: relative adrenal insufficiency? Intensive Care Med. 26:125–127. 2000. View Article : Google Scholar : PubMed/NCBI
12	Korać Z, Krajacić I, Hancević J and Marusić Z: Multiple injuries in peacetime and wartime estimate of severity of injury by the Injury Severity Score and Polytraumaschlüssel. Eur J Surg. 164:563–567. 1998. View Article : Google Scholar : PubMed/NCBI
13	Zhang L, Hu J, Xiao L, Zhang Y, Zhao W, Zheng W and Shang H: Adverse drug reactions of Shenmai injection: a systematic review. J Evid Based Med. 3:177–182. 2010. View Article : Google Scholar : PubMed/NCBI
14	Okonkwo KC, Wong KG, Cho CT and Gilmer L: Testicular trauma resulting in shock and systemic inflammatory response syndrome: a case report. Cases J. 1:42008. View Article : Google Scholar : PubMed/NCBI
15	Punyadeera C, Schneider EM, Schaffer D, Hsu HY, Joos TO, Kriebel F, Weiss M and Verhaegh WF: A biomarker panel to discriminate between systemic inflammatory response syndrome and sepsis and sepsis severity. J Emerg Trauma Shock. 3:26–35. 2010. View Article : Google Scholar : PubMed/NCBI
16	Seymour CW and Rosengart MR: Septic shock: Advances in diagnosis and treatment. JAMA. 314:708–717. 2015. View Article : Google Scholar : PubMed/NCBI
17	Hofmann N, Zipperle J, Jafarmadar M, Ashmwe M, Keibl C, Penzenstadler C, Ponschab M, Jafarmadar B, Redl H, Bahrami S, et al: Experimental models of endotheliopathy: impact of shock severity. Shock. 49:564–571. 2018. View Article : Google Scholar : PubMed/NCBI
18	White NJ, Martin EJ, Brophy DF and Ward KR: Examining platelet-fibrin interactions during traumatic shock in a swine model using platelet contractile force and clot elastic modulus. Blood Coagul Fibrinolysis. 22:379–387. 2011. View Article : Google Scholar : PubMed/NCBI
19	Gür A, Oguzturk H, Köse A, Turtay MG, Ersan V, Bayindir Y, Ince V, Gurbuz S and Yucel N: Prognostic value of procalcitonin, CRP, serum amyloid A, lactate and IL-6 markers in liver transplant patients admitted to ED with suspected infection. In Vivo. 31:1179–1185. 2017.PubMed/NCBI
20	Rule JA, Hynan LS, Attar N, Sanders C, Korzun WJ and Lee WM; Acute Liver Failure Study Group, : Procalcitonin identifies cell injury, not bacterial infection, in acute liver failure. PLoS One. 10:e01385662015. View Article : Google Scholar : PubMed/NCBI
21	Togari H, Sugiyama S, Ogino T, Suzuki S, Ito T, Ichiki T, Kamiya K, Watanabe I, Ogawa Y, Wada Y, et al: Interactions of endotoxin with cortisol and acute phase proteins in septic shock neonates. Acta Paediatr Scand. 75:69–74. 1986. View Article : Google Scholar : PubMed/NCBI
22	Ahmed AI, Soliman RA and Samir S: Cell free DNA and procalcitonin as early markers of complications in ICU patients with multiple trauma and major surgery. Clin Lab. 62:2395–2404. 2016. View Article : Google Scholar : PubMed/NCBI
23	Chirapongsathorn S, Bunraksa W, Chaiprasert A, Punpanich D, Supasyndh O and Kamath PS: Adding C-reactive protein and procalcitonin to the model of end-stage liver disease score improves mortality prediction in patients with complications of cirrhosis. J Gastroenterol Hepatol. 33:726–732. 2018. View Article : Google Scholar : PubMed/NCBI
24	Alexandrov PN, Kruck TP and Lukiw WJ: Nanomolar aluminum induces expression of the inflammatory systemic biomarker C-reactive protein (CRP) in human brain microvessel endothelial cells (hBMECs). J Inorg Biochem. 152:210–213. 2015. View Article : Google Scholar : PubMed/NCBI
25	Braig D, Nero TL, Koch HG, Kaiser B, Wang X, Thiele JR, Morton CJ, Zeller J, Kiefer J, Potempa LA, et al: Transitional changes in the CRP structure lead to the exposure of proinflammatory binding sites. Nat Commun. 8:141882017. View Article : Google Scholar : PubMed/NCBI
26	Yang R, Han X, Uchiyama T, Watkins SK, Yaguchi A, Delude RL and Fink MP: IL-6 is essential for development of gut barrier dysfunction after hemorrhagic shock and resuscitation in mice. Am J Physiol Gastrointest Liver Physiol. 285:G621–G629. 2003. View Article : Google Scholar : PubMed/NCBI
27	Gu FM, Li QL, Gao Q, Jiang JH, Zhu K, Huang XY, Pan JF, Yan J, Hu JH, Wang Z, et al: IL-17 induces AKT-dependent IL-6/JAK2/STAT3 activation and tumor progression in hepatocellular carcinoma. Mol Cancer. 10:1502011. View Article : Google Scholar : PubMed/NCBI