Usefulness of presepsin in the diagnosis of sepsis in a multicenter prospective study
Usefulness of presepsin in the diagnosis of sepsis in a multicenter prospective study
复制标题
DOI：
10.1007/s10156-012-0435-2
复制
发表时间：
2012-12-01
影响因子：
2.2
通讯作者：
Okamura, Yoshikazu
中科院分区：
文献类型：
--
作者：
Endo, Shigeatsu;Suzuki, Yasushi;Okamura, Yoshikazu
在一项多中心前瞻性研究中，研究了Presepsin在区分细菌和非细菌感染(包括全身炎症反应综合征)方面的临床有效性，并与降钙素原(PCT)和白介素6(IL-6)进行了比较。207例疑似脓毒症患者纳入研究。全身性细菌感染和局限性细菌感染患者的Presepsin水平明显高于非细菌感染患者。此外，细菌感染性疾病患者的Presepsin、PCT和IL-6水平显著高于非细菌感染性疾病患者(P<；0.0001、P<；0.0001和P<；0.0001)。细菌感染性疾病和非细菌感染性疾病患者受试者工作特征曲线下面积分别为：Presepsin 0.908，PCT 0.905，IL-6 0.825。Preepsin鉴别细菌性和非细菌性感染性疾病的临界值为600pg/ml，其临床敏感性和特异性分别为87.8%和81.4%。在革兰氏阳性和革兰氏阴性细菌感染患者中，前列环素水平没有显著差异。血培养的敏感性为35.4%，前列环素的敏感性为91.9%。此外，血培养阳性组和血培养阴性组的前列环素水平也没有显著差异。因此，Preepsin对脓毒症的诊断是有用的，而且它优于传统的标志物和血培养。
The clinical usefulness of presepsin for discriminating between bacterial and nonbacterial infections (including systemic inflammatory response syndrome) was studied and compared with procalcitonin (PCT) and interleukin-6 (IL-6) in a multicenter prospective study. Suspected sepsis patients (n = 207) were enrolled into the study. Presepsin levels in patients with systemic bacterial infection and localized bacterial infection were significantly higher than in those with nonbacterial infections. In addition, presepsin, PCT, and IL-6 levels in patients with bacterial infectious disease were significantly higher than in those with nonbacterial infectious disease (P < 0.0001, P < 0.0001, and P < 0.0001, respectively). The area under the receiver operating characteristic curve was 0.908 for presepsin, 0.905 for PCT, and 0.825 for IL-6 in patients with bacterial infectious disease and those with nonbacterial infectious disease. The cutoff value of presepsin for discrimination of bacterial and nonbacterial infectious diseases was determined to be 600 pg/ml, of which the clinical sensitivity and specificity were 87.8 % and 81.4 %, respectively. Presepsin levels did not differ significantly between patients with gram-positive and gram-negative bacterial infections. The sensitivity of blood culture was 35.4 %; that for presepsin was 91.9 %. Also there were no significant differences in presepsin levels between the blood culture-positive and -negative groups. Consequently, presepsin is useful for the diagnosis of sepsis, and it is superior to conventional markers and blood culture.