中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2015年
8期
819-824
,共6页
刘波%陈云霞%李薇%李春盛
劉波%陳雲霞%李薇%李春盛
류파%진운하%리미%리춘성
Presepsin%降钙素%脓毒症%器官功能障碍%脓毒症相关器官功能障碍评分%感染%炎症%生物标记物
Presepsin%降鈣素%膿毒癥%器官功能障礙%膿毒癥相關器官功能障礙評分%感染%炎癥%生物標記物
Presepsin%강개소%농독증%기관공능장애%농독증상관기관공능장애평분%감염%염증%생물표기물
Presepsin%Procalcitonin%Sepsis%Organ dysfunction%Sepsis-related organ failure assessment score%Infection%Inflammation%Biomarker
目的 本研究探讨入院时Presepsin水平对于急诊室脓毒症患者发生多器官功能障碍(MOD)的预测作用.方法 采用前瞻性研究方法,入选2013年11月至2014年10月北京朝阳医院急诊科连续就诊的脓毒症患者680例作为研究对象,记录发生MOD及非MOD的患者,并记录Presepsin、PCT水平和SOFA评分的分值.结果 入院时MOD组Presepsin质量浓度为1 023.5(728.3 ～1 860.0)pg/mL显著高于非MOD组334.0(218.0 ～479.5) pg/mL.不同类型器官功能障碍的Presepsin质量浓度比较差异无统计学意义;Presepsin在不同数量器官功能障碍的中位数质量浓度分别为:无器官功能障碍235.0(172.0～ 340.3)pg/mL,1个器官功能障碍403.5 (275.8 ～ 587.3) pg/mL,2个器官功能障碍844.5(559.8 ～1 259.5)pg/mL,3个或3个以上器官功能障碍1412.5 (893.0～2 675.8) pg/mL,差异具有统计学意义(P＜0.01).Presepsin、PCT和SOFA评分为脓毒症患者发生MOD的独立预测因子;Presepsin预测MOD的ROC曲线下面积(AUCs)为0.914,明显高于PCT (0.756)和SOFA评分(0.840).结论 Presepsin水平在不同类型器官功能障碍的比较差异无统计学意义,Presepsin水平随着脓毒症患者器官功能障碍数量的增加而增加,Presepsin在预测MOD方面优于PCT和SOFA评分.
目的 本研究探討入院時Presepsin水平對于急診室膿毒癥患者髮生多器官功能障礙(MOD)的預測作用.方法 採用前瞻性研究方法,入選2013年11月至2014年10月北京朝暘醫院急診科連續就診的膿毒癥患者680例作為研究對象,記錄髮生MOD及非MOD的患者,併記錄Presepsin、PCT水平和SOFA評分的分值.結果 入院時MOD組Presepsin質量濃度為1 023.5(728.3 ～1 860.0)pg/mL顯著高于非MOD組334.0(218.0 ～479.5) pg/mL.不同類型器官功能障礙的Presepsin質量濃度比較差異無統計學意義;Presepsin在不同數量器官功能障礙的中位數質量濃度分彆為:無器官功能障礙235.0(172.0～ 340.3)pg/mL,1箇器官功能障礙403.5 (275.8 ～ 587.3) pg/mL,2箇器官功能障礙844.5(559.8 ～1 259.5)pg/mL,3箇或3箇以上器官功能障礙1412.5 (893.0～2 675.8) pg/mL,差異具有統計學意義(P＜0.01).Presepsin、PCT和SOFA評分為膿毒癥患者髮生MOD的獨立預測因子;Presepsin預測MOD的ROC麯線下麵積(AUCs)為0.914,明顯高于PCT (0.756)和SOFA評分(0.840).結論 Presepsin水平在不同類型器官功能障礙的比較差異無統計學意義,Presepsin水平隨著膿毒癥患者器官功能障礙數量的增加而增加,Presepsin在預測MOD方麵優于PCT和SOFA評分.
목적 본연구탐토입원시Presepsin수평대우급진실농독증환자발생다기관공능장애(MOD)적예측작용.방법 채용전첨성연구방법,입선2013년11월지2014년10월북경조양의원급진과련속취진적농독증환자680례작위연구대상,기록발생MOD급비MOD적환자,병기록Presepsin、PCT수평화SOFA평분적분치.결과 입원시MOD조Presepsin질량농도위1 023.5(728.3 ～1 860.0)pg/mL현저고우비MOD조334.0(218.0 ～479.5) pg/mL.불동류형기관공능장애적Presepsin질량농도비교차이무통계학의의;Presepsin재불동수량기관공능장애적중위수질량농도분별위:무기관공능장애235.0(172.0～ 340.3)pg/mL,1개기관공능장애403.5 (275.8 ～ 587.3) pg/mL,2개기관공능장애844.5(559.8 ～1 259.5)pg/mL,3개혹3개이상기관공능장애1412.5 (893.0～2 675.8) pg/mL,차이구유통계학의의(P＜0.01).Presepsin、PCT화SOFA평분위농독증환자발생MOD적독립예측인자;Presepsin예측MOD적ROC곡선하면적(AUCs)위0.914,명현고우PCT (0.756)화SOFA평분(0.840).결론 Presepsin수평재불동류형기관공능장애적비교차이무통계학의의,Presepsin수평수착농독증환자기관공능장애수량적증가이증가,Presepsin재예측MOD방면우우PCT화SOFA평분.
Objective The present study aimed to explore the value of plasma Presepsin levels for predicting the incidence of multiple organs dysfunction (MOD) in septic patients in an emergency department (ED).Methods A prospective observational study was performed in the ED of Beijing Chao～Yang Hospital from November 2013 to October 2014.A total of 680 septic patients were consecutively enrolled.The septic patients who developed MOD or non-MOD were recorded.Plasma Presepsin and serum procalcitonin (PCT) levels were detected,and sepsis-related organ failure assessment (SOFA) score were calculated upon ED arrival.Results Plasma Presepsin levels at ED admission were significantly higher in patients with MOD [1023.5 (728.3-1 860.0) pg/mL] than in those without MOD [334.0 (218.0-479.5) pg/mL],and were not different between different types of organ dysfunction.Median Presepsin levels in septic patients with different numbers of organ dysfunction were 235.0 (172.0-340.3) pg/mL in those with no organ dysfunction,403.5 (275.8-587.3) pg/mL in those with one organ dysfunction,844.5 (559.8-1 259.5) pg/mL in those with two organs dysfunction,and 1 412.5 (893.0-2 675.8)pg/mL in those with three or more than organs dysfunction,respectively,which was statistically significant between every two groups.Presepsin,PCT and SOFA score were all the independent predictors of MOD.The areas under ROC curve (AUCs) of Presepsin for predicting MOD were 0.914,significantly higher than that of PCT (0.756) and SOFA score (0.840),respectively.Conclusions Plasma Presepsin levels were not different between different types of organ dysfunction.Presepsin levels increased with increasing numbers of organ dysfunction in septic patients,and Presepsin was superior to PCT and SOFA score in predicting the incidence of MOD.In conclusion,Presepsin was a valuable biomarker in evaluating MOD in septic patients in ED.
