Value of heparin-binding protein versus procalcitonin and C-reactive protein in the early diagnosis of childhood sepsis

Abstract

Objective To investigate the clinical application value of blood heparin-binding protein (HBP), procalcitonin (PCT), and C-reactive protein(CRP) in the early diagnosis of childhood sepsis. Methods A retrospective analysis was performed for 20 children with general sepsis (general sepsis group), 16 children with severe sepsis (severe sepsis group), and 12 children with septic shock (septic shock group) who were admitted to the pediatric intensive care unit and the neonatal intensive care unit of our hospital from November 2017 to May 2019, and 22 non-sepsis children with local infection (local infection control group) and 18 children with non-infectious disease (non-infection control group) who were admitted to the general ward during the same period of time were enrolled as control group. The levels of blood HBP, PCT, and CRP were measured and compared between groups, and the receiver operating characteristic (ROC) curve was used to investigate the value of each index in the early diagnosis of sepsis. Results The septic shock group had significantly higher levels of blood HBP and PCT than the severe sepsis group and the general sepsis group (P<0.05), and the severe sepsis group and the general sepsis group had significantly higher levels of blood HBP and PCT than the local infection control group and the non-infection control group (P<0.05). There was no significant diffe-rence in blood CRP between the septic shock group, the severe sepsis group, and the general sepsis group (P>0.05), but all these three groups had a significantly higher level of blood CRP than the non-infection control group (P<0.05). HBP had a significantly larger area under the ROC curve than PCT and CRP in the diagnosis of childhood sepsis (0.984 vs 0.954/0.897), and HBP had the best diagnostic performance at the cut-off value of 28.225 μg/L, with a sensitivity of 94.4% and a specificity of 96.9%. Conclusion HBP has a higher application value than PCT and CRP in the early diagnosis of childhood sepsis and has a similar value to PCT in terms of clinical classification, and therefore, it can be used to guide clinical practice.

Keywords

• sepsis|heparin binding protein|procalcitonin|c-reactive protein|early diagnosis|child