Association of the immature platelet fraction with sepsis diagnosis and severity
Association of the immature platelet fraction with sepsis diagnosis and severity
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DOI：
10.1038/srep08019
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发表时间：
2015-01-26
影响因子：
4.6
通讯作者：
De Paula, Erich Vinicius
中科院分区：
文献类型：
--
作者：
Enz Hubert, Rodolfo Monteiro;Rodrigues, Melina Veiga;De Paula, Erich Vinicius
脓毒症的管理将大大受益于在临床实践中纳入简单和信息丰富的新生物标志物。理想情况下，脓毒症生物标志物应该将感染患者与非感染患者分开，提供有关预后和器官特异性损伤的信息，并可用于大多数医疗服务。未成熟血小板分数（IPF）和未成熟网织红细胞分数（IRF）是全血细胞计数的新分析参数，已被研究为几种炎症性疾病的生物标志物。最近，在危重患者中进行的一项研究表明，IPF可能是比C反应蛋白（CRP）和降钙素原更准确的脓毒症生物标志物。在这项回顾性研究中，我们评价了IPF和IRF作为脓毒症诊断和严重程度生物标志物的性能。对入住两个重症监护室的41名患者进行了评价，其中12名患有严重脓毒症或脓毒性休克，11名患有非并发性脓毒症。在重度脓毒症/脓毒性休克患者中观察到IPF水平显著较高。IPF与脓毒症严重程度评分相关，并且在所有研究的临床和实验室参数中对脓毒症的诊断准确性最高。未观察到IRF水平的显著差异。我们的研究结果表明，IPF水平可用作脓毒症诊断和严重程度的生物标志物。
Management of Sepsis would greatly benefit from the incorporation of simple and informative new biomarkers in clinical practice. Ideally, a sepsis biomarker should segregate infected from non-infected patients, provide information about prognosis and organ-specific damage, and be accessible to most healthcare services. The immature platelet fraction (IPF) and immature reticulocyte fraction (IRF) are new analytical parameters of the complete blood count, that have been studied as biomarkers of several inflammatory conditions. Recently, a study performed in critically-ill patients suggested that IPF could be a more accurate sepsis biomarker than C-reactive protein (CRP) and procalcitonin. In this retrospective study we evaluated the performance of IPF and IRF as biomarkers of sepsis diagnosis and severity. 41 patients admitted to two intensive care units were evaluated, 12 of which with severe sepsis or septic shock, and 11 with non-complicated sepsis. Significantly higher IPF levels were observed in patients with severe sepsis/septic shock. IPF correlated with sepsis severity scores and presented the highest diagnostic accuracy for the presence of sepsis of all studied clinical and laboratory parameters. No significant differences were observed in IRF levels. Our results suggest that IPF levels could be used as a biomarker of sepsis diagnosis and severity.