presepsin与c反应蛋白在脓毒症诊断和预后中的作用

IF 0.3 Q4 CRITICAL CARE MEDICINE Egyptian Journal of Critical Care Medicine Pub Date : 2017-04-01 DOI:10.1016/j.ejccm.2017.02.001
Mohamed El-Saied El-Shafie , Khaled M. Taema , Moataz M. El-Hallag , Abdallah Mohamed Abdallah Kandeel
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引用次数: 15

摘要

脓毒症的早期识别及其与非感染性SIRS的区分对脓毒症的预后很重要。我们打算评估presesin在区分脓毒症和非感染性SIRS中的应用及其与CRP的预后价值。我们纳入了埃及El-Sahel教学医院收治的31例SIRS患者(中位年龄60岁,16例男性),排除了21例入院前皮质类固醇治疗、输血、免疫抑制疾病和ICU住院时间(ICU- los)少于24小时的患者。患者分为非感染性SIRS组(13例)和脓毒症组(18例)。入院时、入院第2天、第4天分别测定Presepsin、CRP和SOFA评分。研究的结局参数为ICU-LOS和住院生存率。除脓毒症组体温和谷草转氨酶明显升高外,两组具有可比性。脓毒症患者在第2天和第4天的所有presepsin水平和CRP水平均显著高于SIRS组。ICU-LOS与第2、4天的各项presepsin水平及CRP水平呈正相关。幸存者的所有血压值均显著升高,而幸存者和非幸存者的CRP水平无显著差异。随着时间的推移,胃蛋白酶的减少与更好的生存率显著相关。在预测SIRS患者的生存时,发现其敏感性为70%,特异性为91%。在CRP水平中没有发现这种关系。我们的结论是,presepsin可以用于脓毒症和非感染性SIRS的早期区分,并预测更高的死亡率。
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Role of presepsin compared to C-reactive protein in sepsis diagnosis and prognostication

Early identification of sepsis and its differentiation from non-infective SIRS are important for sepsis outcome. We intended to evaluate the use of presepsin in differentiating sepsis from noninfectious SIRS and its prognostic value compared to CRP. We included 31 patients (median age 60 year old, 16 males) admitted with SIRS to El-Sahel Teaching Hospital, Egypt after excluding 21 patients with preadmission corticosteroids therapy, blood transfusion, immunosuppressive illness, and ICU length of stay (ICU-LOS) less than 24-hours. Patients were classified into non-infective SIRS group (13 patients) and sepsis group (18 patients). Presepsin, CRP and SOFA score were measured on admission and on days 2 and 4 of admission. The outcome parameters studied were ICU-LOS and in-hospital survival. Apart from temperature and AST which were significantly higher in sepsis group, the two groups were comparable. All the presepsin levels and CRP on days 2 and 4 were significantly higher in sepsis than in SIRS groups. The ICU-LOS was positively correlated with all the presepsin levels and with the CRP levels on days 2 and 4. All presepsin values were significantly higher in survivors while none of the CRP levels were significantly different in survivors and non-survivors. The decrease of presepsin over time was significantly associated with better survival. It was found to be 70% sensitive and 91% specific for predicting survival in SIRS patients. This relation was not found in CRP levels. We concluded that the presepsin can be used for early differentiation between sepsis and non-infectious SIRS and predict higher mortality.

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来源期刊
自引率
0.00%
发文量
5
审稿时长
42 weeks
期刊介绍: The Egyptian Journal of Critical Care Medicine is the official Journal of the Egyptian College of Critical Care Physicians, the most authoritative organization of Egyptian physicians involved in the multi-professional field of critical care medicine. The journal is intended to provide a peer-reviewed source for multidisciplinary coverage of general acute and intensive care medicine and its various subcategories including cardiac, pulmonary, neuro, renal as well as post-operative care. The journal is proud to have an international multi-professional editorial board in the broad field of critical care that will assist in publishing promising research and breakthrough reports that lead to better patients care in life threatening conditions, and bring the reader a quick access to the latest diagnostic and therapeutic approaches in monitoring and management of critically ill patients.
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