The clinical value of pro-atrial natriuretic peptide in sepsis early specifical diagnosis.

Objective To evaluate the clinical value of pro-atrial natriuretic peptide(pro-ANP)in early specifical diagnosis of sepsis.Methods We performed prospective trial.According to the international sepsis criteria,51 critically ill patients admitted to the intensive care unit were classified into four groups:systemic inflammatory response syndrome(SIRS,25),sepsis(12),severe sepsis(9)and septic shock(5),with 53 age-matched healthy individuals as control groups.The level of plasma pro-ANP was measured in each group,and compared with the other biomarkers(i.e.procalcitonin,C-reactive protein and IL-6)and the Acute Physiology and Chronic Health Evaluation(APACHE)Ⅱ scorewas obtained.pro-ANP was detected using a new sandwich immunoassay.Results Median pro-ANP concentration was 87.22μg/L for SIRS,533.30 for sepsis,1098.73 for severe sepsis and 1933.94 for septic shock,the plasma concentration of pro-ANP exhibited a gradual increase,and the median pro-ANP value was greatest in the septic shock group.Comparing with the other biomarkers,in the sepsis,severe sepsis and septic shock groups,the plasma concentration of pro-ANP in the nonsurvivors was significantly greater than in the survivors(P0.05),and the difference in pro-ANP values was clear on the first day of admission to the ICU(P0.05).By the receiver operating characteristic(ROC)plot analysis of pro-ANP in sepsis patients,the area under the ROC curve for pro-ANP was similar to the area under the ROC curve for PCT and APACHEⅡ score,and was significantly higher than the area under the ROC curve for CRP and IL-6.Conclusion The measurement of pro-ANP has great clinical value in the early specifical diagnosis and risk assessment in sepsis.