Evaluative value of dynamic observation of prealbumin,C-reactive protein and D-dimer in patients with pneumonia septic shock

Objective To study the changes of Prealbumin (PA),C-reactive protein (CRP) and D-dimer (DD) levels in septic shock patients due to pneumonia so as to explore the relation to the severity of disease and prognosis.Methods PA,CRP and DD levels of 48 sepsis patients were measured on 1st 、 3rd、5th day after admission and the last day before discharge or death.Meanwhile APACHE Ⅱ score were documented.According to prognosis,patients were divided into death group and non-death group.Results The levels of PA、CRP and DD on the 1 st day were of no significant difference between the death group and non-death group( t = 2.315 ,P ＞ 0.05;t =2.013,P ＞0.05; t =2.511 ,P ＞0.05).The level of PA in death group on the 3rd day,the 5th day and the last day was much lower than that in non-death group ( t = 2.422,P ＜ 0.05; t = 2.557,P ＜ 0.05; t = 2.906,P ＜ 0.05 ).The level of CRP and DD in death group on the 3rd day,the 5th day and the last day was much higher than those in nondeath group(t =2.061 ,P ＜0.05 ;t =2.843,P ＜0.05 ,t =3.519,P ＜0.01 and t = 2.576,P ＜0.05,t = 2.823,P ＜0.05; t = 3.371 ,P ＜ 0.01 ).There was a negative correlation between PA and APACHE Ⅱ scores ( r = - 0.631,P ＜0.01 ) ,while a positive correlation was found between CRP,DD and APACHE Ⅱ score(r =0.687 ,P ＜0.01 and r =0.651 ,P ＜ 0.01 ).Conclusions Persistent low level of PA and high level of CRP,DD indicated severe disease course and unflavored prognosis.It is of clinical value to evaluate the severity of disease and predict prognosis in sepsis by combined dynamic observation of PA,CRP and DD levels. Key words: Pneumonia; Septic shock; C-reactive protein; Prealbumin; D-dimer