[Clinical significance of detection of thrombus precursor protein in severe sepsis]

To evaluate the significance of the changes in plasma thrombus precursor protein (TPP) in severe sepsis.

Enzyme linked immunoadsorbent assay (ELISA) was used in the determination of plasma TPP in 22 patients with severe sepsis group. Prothrombin time (PT), activated partial thromboplastin time(APTT), fibrin(Fib), D-Dimer were also determined and the values were compared with those obtained from 10 patients with infection and 8 healthy normal controls. At the same time, scores of sepsis related organ failure assessment(SOFA), simplified acute physiology score (SAPSII), Marshall criteria were made respectively in patients with severe sepsis on 1,3,5 days after admission to the ICU. Analysis of correlation between TPP and scores was done.

(1)The concentration of TPP and positive rate of D-Dimer in severe sepsis were obviously higher than that in the ordinary infection group and normal control group (all P<0.05). But there were no differences in levels of PT, APTT, and Fib among three groups. (2)The concentration of TPP rose continuously in nonsurvivors due to severe sepsis, and it was positively correlated with scores of SOFA, SAPSII, Marshall criteria.

TPP levels showed a higher specificity and sensitivity in detecting hypercoagulability state in severe than D-Dimer, PT, APTT, Fib assay. It can be used as a diagnostic and prognostic parameter for early hypercoagulability states and outcome of severe sepsis.