Serum Soluble ST2 as Diagnostic Marker of Systemic Inflammatory Reactive Syndrome of Bacterial Etiology in Children
Serum Soluble ST2 as Diagnostic Marker of Systemic Inflammatory Reactive Syndrome of Bacterial Etiology in Children
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血清可溶性 ST2 作为儿童细菌性病因系统炎症反应综合征的诊断标志物
DOI：
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发表时间：
2014
期刊：
影响因子：
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通讯作者：
P. D’argenio
中科院分区：
文献类型：
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作者：
F. C. Calò Carducci;Lelia Rotondi Aufiero;L. Folgori;A. Vittucci;D. Amodio;M. De Luca;G. Li Pira;A. Bergamini;G. Pontrelli;A. Finocchi;P. D’argenio
背景：准确、及时地诊断全身炎症反应综合征（SIRS）儿童的社区获得性细菌与病毒感染对于临床医生和实验室来说仍然是一个挑战。在寻找新的生化标志物来区分细菌和病毒感染的过程中，我们探索了可溶性分泌形式的 ST2 (sST2) 的可能作用。方法：这项探索性前瞻性队列研究纳入了疑似社区获得性感染的 SIRS 儿童。用于 sST2 测量的血浆样本取自 64 名住院儿童，其中 41 名儿童患有细菌性病因 SIRS，23 名儿童患有病毒性病因 SIRS，以及 20 名年龄和性别匹配的健康对照儿童。 sST2 测量通过酶联免疫吸附测定与降钙素原 (PCT) 和 C 反应蛋白 (CRP) 的标准测量并行进行。结果：我们的研究结果表明，与病毒性 SIRS 患者和健康儿童相比，细菌感染相关 SIRS 儿童的 sST2 水平显着升高。更重要的是，接受者操作特征曲线分析表明，sST2对于细菌性病原学SIRS的早期识别具有显着的诊断性能，其诊断性能与PCT相似，且优于CRP。最后，与单独使用 sST2、PCT 和 CRP 相比，sST2 加 PCT 和/或 CRP 以及 PCT 加 CRP 的组合提高了其敏感性和阴性预测值。结论： 总之，sST2 水平可能有助于预测 SIRS 儿童的细菌病因。
Background: Accurate and timely diagnosis of community-acquired bacterial versus viral infections in children with systemic inflammatory response syndrome (SIRS) remains challenging both for clinician and laboratory. In the quest of new biochemical markers to distinguish bacterial from viral infection, we have explored the possible role of the soluble secreted form of ST2 (sST2). Methods: This explorative prospective cohort study included children with SIRS who were suspected of having community-acquired infections. Plasma samples for sST2 measurement were obtained from 64 hospitalized children, 41 of whom had SIRS of bacterial etiology and 23 SIRS of viral etiology, and from 20 healthy, age- and sex-matched control children. sST2 measurement was carried out by enzyme-linked immunosorbent assay in parallel with standard measurements of procalcitonin (PCT) and C reactive protein (CRP). Results: Our findings demonstrate that children with SIRS associated with bacterial infection present significantly increased levels of sST2, when compared with patients with SIRS of viral etiology and healthy children. More important, receiver operating characteristic curve analysis indicated that sST2 has a significant diagnostic performance with respect to early identification of SIRS of bacterial etiology, which was similar to that of PCT and greater than that of CRP. Finally, the combination of sST2 plus PCT and/or CRP, and PCT plus CRP increased their sensitivity and negative predictive value compared with sST2, PCT and CRP alone. Conclusions: In conclusion, sST2 level may prove useful in predicting bacterial etiology in children with SIRS.
影响因子：
15.9
作者：
Sanada, Shoji;Hakuno, Daihiko;Lee, Richard T.
通讯作者：
Lee, Richard T.