Usefulness of presepsin (sCD14-ST) measurements as a marker for the diagnosis and severity of sepsis that satisfied diagnostic criteria of systemic inflammatory response syndrome
Usefulness of presepsin (sCD14-ST) measurements as a marker for the diagnosis and severity of sepsis that satisfied diagnostic criteria of systemic inflammatory response syndrome
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DOI：
10.1007/s10156-011-0254-x
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发表时间：
2011-12-01
影响因子：
2.2
通讯作者：
Endo, Shigeatsu
中科院分区：
文献类型：
--
作者：
Shozushima, Tatsuyori;Takahashi, Gaku;Endo, Shigeatsu
CD14存在于巨噬细胞、单核细胞和粒细胞细胞及其细胞膜中，据说它负责内毒素信号的细胞内转导。它的可溶性部分存在于血液中，被认为与感染有关。它被称为可溶性cd14亚型（sCD14-ST），在下面的文本中，它被称为其通用名称presepsin。我们以前报道过，胃蛋白酶与感染有关，并在脓毒症中特异性表达。在本研究中，我们开发了一种新的快速诊断方法，使用化学发光酶免疫分析法，可以在更短的时间内进行自动测量。用该方法测定不同病理状态下的血压值均为正常，294.2 +/- A 121.4 pg/ml；局部感染721.0 +/- A 611.3 pg/ml；全身性炎症反应综合征，333.5 +/- A 130.6 pg/ml；脓毒症，817.9 +/- A 572.7 pg/ml；严重脓毒症，1,992.9 +/- A 1509.2 pg/ml；局部感染、脓毒症和严重脓毒症患者的presepsin值明显高于没有感染并发症的患者。在一项基于ROC曲线与其他脓毒症诊断指标的比较研究中，presepsin的曲线下面积（AUC）为0.845，大于降钙素原（PCT, 0.652）、c反应蛋白（CRP, 0.815）、白细胞介素6 （IL-6, 0.672）的AUC。此外，疾病严重程度指标APACHE II评分与presepsin值之间存在显著相关性，提示presepsin值可以作为密切反映病理的参数。
CD14 is present in macrophage, monocyte, and granulocyte cells and their cell membranes, and it is said to be responsible for intracellular transduction of endotoxin signals. Its soluble fraction is present in blood and is thought to be produced in association with infections. It is called the soluble CD14-subtype (sCD14-ST), and in the following text it is referred to by its generic name, presepsin. We have previously reported that presepsin is produced in association with infection and that it is specifically expressed in sepsis. In the present study we developed a new rapid diagnostic method by using a chemiluminescent enzyme immunoassay that allowed making automated measurements in a shorter time. The results of using this method to measure presepsin values in different pathological conditions were normal, 294.2 +/- A 121.4 pg/ml; local infection, 721.0 +/- A 611.3 pg/ml; systemic inflammatory response syndrome, 333.5 +/- A 130.6 pg/ml; sepsis, 817.9 +/- A 572.7 pg/ml; and severe sepsis, 1,992.9 +/- A 1509.2 pg/ml; the presepsin values were significantly higher in patients with local infection, sepsis, and severe sepsis than in patients who did not have infection as a complication. In a comparative study with other diagnostic markers of sepsis based on ROC curves, the area under the curve (AUC) of presepsin was 0.845, and greater than the AUC of procalcitonin (PCT, 0.652), C-reactive protein (CRP, 0.815), or interleukin 6 (IL-6, 0.672). In addition, a significant correlation was found between the APACHE II scores, an index of disease severity, and the presepsin values, suggesting that presepsin values can serve as a parameter that closely reflects the pathology.