Prognostic value of the combination of serum ACTH level and procalcitonin change rate in uro-genic sepsis
Objective To investigate the prognostic value of the combination of serum adreno-corticotropic hormone(ACTH)level and the change rate of procalcitonin(PCT)in urosepsis.Meth-ods From January 2021 to March 2022,76 patients with urogenic sepsis after percutaneous nephro-scopic or ureteroscopic surgery for upper urinary tract calculi admitted to our hospital were selected as the study objects.They were divided into survival group and death group according to the survival con-ditions of patients 14 days after diagnosis.Enzyme linked immunosorbent assay(ELISA)was used to detect the serum ACTH level of patients and the serum PCT level of patients on the day of diagnosis and the second day after diagnosis,and calculate the PCT change rate.Spearman correlation analysis was applied to analyze the correlation of serum ACTH level,PCT change rate and Sequential Organ Failure Assessment(SOFA).Cox regression analysis was applied to analyze the risk factors affecting the prognosis of patients with urosepsis.Results The glutamic pyruvate transaminase,glutamic ox-alate transaminase,total heme,activated partial thromboplastintime(APTT),serum creatinine and white blood cell count in the death group were higher than those in the survival group,and the hemo-globin in the death group was lower than that in the survival group,and the differences were all statisti-cally significant(all P<0.05).Compared with the death group,serum ACTH levels and SOFA scores were lower and the change rate of PCT was significantly higher in the survival group of patients(all P<0.001).The results of Spearman correlation analysis showed that ACTH level was positively correlated with SOFA score(r=0.533,P<0.001),the change rate of PCT was negatively correlated with SOFA score(r=-0.600,P<0.001).Multivariate Cox regression analysis showed that high ACTH level and the low change rate of PCT were risk factors for poor prognosis in patients with urosep-sis(all P<0.05).Conclusions The serum ACTH level in patients with urosepsis is greatly in-creased,and the change rate of PCT is greatly decreased,and the two are closely related to the progno-sis of patients with urosepsis.