Abstract: 【Objective】 To evaluate the dynamic changes of plasma soluble urokinase plasminogen activator receptor (suPAR) and serum procalcitonin (PCT) and to investigate the prognostic significance of plasma suPAR and serum PCT in patients with sepsis. 【Methods】 The levels of plasma suPAR and serum PCT were monitored in 82 patients with sepsis and 29 patients with systemic inflammatory response syndrome (SIRS). The acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) and sequential organ failure assessment (SOFA) score were recorded. Dynamic changes in the levels of plasma suPAR and serum PCT were compared between the survivor group (n = 51) and non-survivor group (n = 31) on the 1st

3rd

5th

7th day after admission to ICU and at the day of discharge or death. The value of plasma suPAR

serum PCT

APACHEⅡ and SOFA score on predict the prognosis of septic patients were compared. Correlation analysis were carried out on plasma suPAR

serum PCT

APACHEⅡ and SOFA score. 【Results】The levels of plasma suPAR in septic patients (13.89 ± 0.65 ng/mL) were higher than that in SIRS patients (8.22 ± 0.61 ng/mL) and healthy control patients (4.65 ± 0.30 ng/mL) (P all < 0.001). The levels of serum PCT in septic patients (19.18 ± 4.83 ng/mL) were higher than that in SIRS patients (1.10 ± 0.77 ng/mL) (P < 0.001). The levels of plasma suPAR and serum PCT in survivors were in a decreasing trend (P < 0.05). While the levels of plasma suPAR and serum PCT in non-survivors fluctuated at a high level. At each time point

the levels of plasma suPAR in non-survivors were higher than that in survivors (P all < 0.001). There was no significant difference in the levels of serum PCT on the 1st

3rd and 5th day between survivor group and non-survivor group (P all>0.05)

but the levels of serum PCT on 7th day and the day of discharge or death in non-survivor group were significantly higher than that in survivor group (P < 0.05). Receiver operator characteristic curve (ROC curve) of the level of plasma suPAR on the 1st day could distinguish survivors from non-survivors in septic patients

maximal area under curve (AUC) of plasma suPAR was 0.765. The best cut-off value of plasma suPAR to distinguish survivors from non-survivors was 12.01 ng/mL

the sensitivity was 87.1% and the specificity was 72.5%. The AUC was 0.857 when combine suPAR with APACHEⅡscore in distinguishing survivors from non-survivors

which was higher than each single index (suPAR: AUC0.765

APACHEⅡscore: AUC0.83). Positive correlations were found between plasma suPAR and serum PCT(r = 0.326

P < 0.001)

plasma suPAR and APACHE II score (r = 0.492

P < 0.001)

plasma suPAR and SOFA score (r = 0.386

P < 0.001). 【Conclusion】 Dynamic monitoring of the levels of plasma suPAR can help to assess the severity and the prognosis of sepsis in the early stage

while serum PCT can?蒺t. To combine plasma suPAR with APACHEⅡscore may improve the predict accuracy of prognosis in sepsis.