Synovial fluid presepsin as a novel biomarker for the rapid differential diagnosis of native joint septic arthritis from crystal arthritis
Synovial fluid presepsin as a novel biomarker for the rapid differential diagnosis of native joint septic arthritis from crystal arthritis
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DOI：
10.1016/j.ijid.2020.10.030
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发表时间：
2021-01-01
影响因子：
8.4
通讯作者：
Sakai, Takashi
中科院分区：
文献类型：
--
作者：
Imagama, Takashi;Seki, Kazushige;Sakai, Takashi
目的：探讨presepsin能否作为一种新的生物标志物用于鉴别天然关节脓毒性关节炎（NJSA）和晶体关节炎（CA）。方法：本研究纳入75例诊断为NJSA （n = 21）或CA （n = 54）的患者。测定并比较NJSA组和CA组滑膜液和血液中的前高血压素、c反应蛋白和降钙素原。采用受试者工作特征（ROC）曲线分析来区分两组患者。结果：NJSA组滑膜液和血压素显著高于CA组（p < 0.0001和p < 0.01）。与CA组比较，NJSA组滑液压力素的ROC曲线下面积为0.93（敏感性85.7%，特异性85.2%，阳性预测值69.2%，阴性预测值93.9%，阳性似然比5.79，阴性似然比0.17）。在这些测试中，滑液加压素是最准确的。结论：滑液压力素的测定对于NJSA的早期诊断是可靠的，滑液压力素可以作为区分NJSA和CA的一种新的生物标志物。(C) 2020。由爱思唯尔有限公司代表国际传染病学会出版。
Objective: To investigate whether presepsin can be used as a novel biomarker to differentiate between native joint septic arthritis (NJSA) and crystal arthritis (CA).Methods: This study included 75 patients diagnosed with either NJSA (n = 21) or CA (n = 54). Presepsin in synovial fluid and blood, C-reactive protein, and procalcitonin were measured and compared between the NJSA and CA groups. Receiver operating characteristic (ROC) curve analyses were performed to differentiate between the two groups.Results: Synovial fluid and blood presepsin were significantly higher in the NJSA group than in the CA group (p < 0.0001 and p < 0.01, respectively). The area under the ROC curve for synovial fluid presepsin in the NJSA group compared with the CA group was 0.93 (sensitivity 85.7%, specificity 85.2%, positive predictive value 69.2%, negative predictive value 93.9%, positive likelihood ratio 5.79, negative likelihood ratio 0.17). Among the tests, synovial fluid presepsin was the most accurate.Conclusions: Measurement of synovial fluid presepsin is reliable for the early diagnosis of NJSA, and synovial fluid presepsin could be used as a novel biomarker for differentiating between NJSA and CA. (C) 2020 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.