实用医学杂志
實用醫學雜誌
실용의학잡지
THE JOURNAL OF PRACTICAL MEDICINE
2014年
20期
3256-3258
,共3页
脓毒症%Presepsin%降钙素原
膿毒癥%Presepsin%降鈣素原
농독증%Presepsin%강개소원
Sepsis%Presepsin%Procalcitonin
目的：探讨脓毒症患者Presepsin变化的临床意义。方法：选取江苏大学附属医院重症监护病房2011年10月至2013年3月脓毒症患者52例，SIRS患者40例。另选30例健康正常人为对照组。检测各组入院时血浆Presepsin、及降钙素原（PCT）水平，并进行APACHEⅡ评分。对比分析各组患者血浆Presepsin水平、降钙素原水平与APACHEⅡ评分。 ROC曲线分析各指标对脓毒症的诊断性能。结果：死亡组血浆Presepsin、PCT水平及APACHEⅡ评分均显著高于存活组和对照组（P＜0．01）；脓毒症组患者血浆Presepsin、PCT水平高于SIRS组及对照组（P＜0．05）。 APACHEⅡ评分在SIRS组和脓毒症组间比较差异无统计学意义。相关分析显示：血浆Presepsin水平与PCT水平呈正相关性（r ＝0．82），与APACHEⅡ评分呈正相关性（r＝0．69）。 Presepsin的AUC为0．908（95％CI：0．848～0．967）；分界值为629 pg／mL时灵敏度为68．6％，特异度为90％。 PCT的AUC为0．862（95％CI：0．787～0．937）；分界值为1．98 ng／mL时灵敏度为92％，特异度为65％。结论：脓毒症患者血浆中Presepsin升高，Presepsin水平升高提示患者病情危重。
目的：探討膿毒癥患者Presepsin變化的臨床意義。方法：選取江囌大學附屬醫院重癥鑑護病房2011年10月至2013年3月膿毒癥患者52例，SIRS患者40例。另選30例健康正常人為對照組。檢測各組入院時血漿Presepsin、及降鈣素原（PCT）水平，併進行APACHEⅡ評分。對比分析各組患者血漿Presepsin水平、降鈣素原水平與APACHEⅡ評分。 ROC麯線分析各指標對膿毒癥的診斷性能。結果：死亡組血漿Presepsin、PCT水平及APACHEⅡ評分均顯著高于存活組和對照組（P＜0．01）；膿毒癥組患者血漿Presepsin、PCT水平高于SIRS組及對照組（P＜0．05）。 APACHEⅡ評分在SIRS組和膿毒癥組間比較差異無統計學意義。相關分析顯示：血漿Presepsin水平與PCT水平呈正相關性（r ＝0．82），與APACHEⅡ評分呈正相關性（r＝0．69）。 Presepsin的AUC為0．908（95％CI：0．848～0．967）；分界值為629 pg／mL時靈敏度為68．6％，特異度為90％。 PCT的AUC為0．862（95％CI：0．787～0．937）；分界值為1．98 ng／mL時靈敏度為92％，特異度為65％。結論：膿毒癥患者血漿中Presepsin升高，Presepsin水平升高提示患者病情危重。
목적：탐토농독증환자Presepsin변화적림상의의。방법：선취강소대학부속의원중증감호병방2011년10월지2013년3월농독증환자52례，SIRS환자40례。령선30례건강정상인위대조조。검측각조입원시혈장Presepsin、급강개소원（PCT）수평，병진행APACHEⅡ평분。대비분석각조환자혈장Presepsin수평、강개소원수평여APACHEⅡ평분。 ROC곡선분석각지표대농독증적진단성능。결과：사망조혈장Presepsin、PCT수평급APACHEⅡ평분균현저고우존활조화대조조（P＜0．01）；농독증조환자혈장Presepsin、PCT수평고우SIRS조급대조조（P＜0．05）。 APACHEⅡ평분재SIRS조화농독증조간비교차이무통계학의의。상관분석현시：혈장Presepsin수평여PCT수평정정상관성（r ＝0．82），여APACHEⅡ평분정정상관성（r＝0．69）。 Presepsin적AUC위0．908（95％CI：0．848～0．967）；분계치위629 pg／mL시령민도위68．6％，특이도위90％。 PCT적AUC위0．862（95％CI：0．787～0．937）；분계치위1．98 ng／mL시령민도위92％，특이도위65％。결론：농독증환자혈장중Presepsin승고，Presepsin수평승고제시환자병정위중。
Objective To investigate the clinical significance of plasma presepsin levels in patients with sepsis. Methods 92 patients who were admitted to the ICU of the affiliated hospital of Jiangsu University from October 2011 to March 2013 and 30 age-matched healthy controls were enrolled in this study. The patients were divided into three groups: sepsis, SIRS, and control. Plasma presepsin and serum procalcitonin (PCT) were measured, APACHEⅡscore were calculated at enrollment, and ROC curve was used to analyze the performance index for the diagnosis of sepsis. Results Serum levels of presepsin, PCT and APACHEⅡscore were significantly higher in the death group than in the SIRS group and the control group (P<0.01). Serum levels of presepsin and PCT were higher in the sepsis group than in the SIRS group and the control group (P<0.05). There was no significant statistical difference between the SIRS group and the sepsis group in the APACHEⅡ score (detailed in table 1). Level of plasma presepsin was significantly correlated with serum PCT (r = 0.82); plasma presepsin level was related with the APACHEⅡ score (r = 0.69). The area under the curve (AUC) of presepsin was 0.908 (95%CI 0.848~0.967), greater than the AUC of PCT 0.862 (95%CI 0.787~0.937). The cutoff value of presepsin for discrimination of bacterial and nonbacterial infectious diseases was determined to be 629 pg/mL, of which the clinical sensitivity and specificity were 68.6% and 90%, respectively; when the cutoff value of PCT was 1.98 ng/mL, the clinical sensitivity and specificity were 92%and 65%. Conclusions Level of presepsin increases in patients with sepsis, and an elevated presepsin may suggest the severity of sepsis.
