Serum procalcitonin and interleukin-6 levels may help to differentiate systemic inflammatory response of infectious and non-infectious origin
Du, B.; Pan, J.; Chen, D.; Li, Y.
Chinese Medical Journal 116(4): 538-542
2003
ISSN/ISBN: 0366-6999 PMID: 12875718 Document Number: 564516
Objective: To evaluate the efficacy of using procalcitonin (PCT) and interleukin-6 (IL-6) to differentiate sepsis from non-infectious systemic inflammatory response syndrome (SIRS). Methods: We made a prospective study in a general intensive care unit at Peking Union Medical College Hospital. Twenty patients with sepsis and 31 patients with non-infectious SIRS were enrolled in this study. Serum concentrations of PCT, IL-6 and C-reactive protein (CRP) were determined within 24 h after clinical onset of sepsis or non-infectious SIRS. Leukocyte count, percentage of neutrophils, and absolute neutrophil count, as well as maximal body temperature were also recorded. Results: Serum concentrations of PCT, IL-6, and CRP, as well as maximal body temperature, were significantly higher in septic patients (3.6 (1.8, 27.5) mug/L, 810+-516 ng/L, 180+-108 g/L, 38.6+-1.2degreeC) than non-infectious SIRS patients (0.5 (0.2, 1.8) mug/L, 235+-177 ng/L, 109+-70 g/L, 37.9+-0.9degreeC). IL-6 and PCT exhibited the best discriminative power between sepsis and non-infectious SIRS, with sensitivity above 80% and specificity above 70%. A sepsis score with combination of IL-6 and PCT showed the best discriminative power with the area under the receiver operating characteristic curve of 0.923. Conclusions: Assessing IL-6 and PCT levels are more reliable ways to differentiate sepsis from non-infectious SIRS, compared with conventional inflammatory parameters.