The value of neopterin used in diagnosis and risk stratification of sepsis

Objective To explore the value of neopterin (Np) in early diagnosis and risk stratification of sepsis. Methods A total of 82 patients admitted to the emergency department from April 2013 to February 2014 were enrolled in the study. They were divided into two groups: sepsis-free group (n= 8) and sepsis group (n=74). Patients' APACHE II scores were calculated within 24 hours after admission, and then their plasma levels of Np and procalcitonin (PCT) were detected and analysis was carried out to find the correlation between plasma levels of Np, PCT and acute physiology and chronic health evaluation Ⅱ score (APACHE Ⅱ score) in two groups. And 74 patients in sepsis group were further divided into three subgroups according to their APACHE Ⅱ score : Ⅰ subgroup (score ﹤ 15 , n= 27), Ⅱ subgroup (score 15 to 24 , n=32), and Ⅲ subgroup (score > 25 or more, n= 15). The differences in plasma Np and PCT levels were compared among three subgroups and correlation analysis of Np levels with PCT levels and APACHE Ⅱ scores was carried out. Results The plasma levels of Np, PCT and APACHE Ⅱ scores in sepsis group were higher than those in sepsis-free group (P<0.05). In sepsis group, the plasma levels of Np and PCT were gradually increased with the increasing severity of sepsis (P<0.05); In sepsis group, the plasma levels of Np, PCT and APACHE Ⅱ scores were positively correlated (P<0.01). The area under receiver operating characteristic curve (ROC) of Np was 0.79 and the area under ROC of PCT was 0.75, both of which had high diagnostic accuracy. Conclusions Neopterin has greatly useful value in early diagnosis and risk stratification of sepsis. Key words: Neopterin; Procalcitonin; Sepsis; APACHE Ⅱ score; Receiver operating characteristic curve; Application value