脓毒症的生物标志物:CRP、降钙素原和胃泌素在脓毒症中的诊断和预后意义。

Vineeta Baxla, Ashok Kumar Sharma, Kumari Seema, Abhay Kumar, Manju Boipai, Pradip Kumar Bhattacharya, Manoj Kumar
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引用次数: 0

摘要

背景:无可否认,脓毒症是一个严重的全球健康威胁,每年造成数百万人死亡,对临床医生来说是一个真正的诊断挑战。传统的标准培养方法往往是消极的,耗时;因此,选择性特异性和易于测量的生物标志物可以帮助预测败血症的诊断和预后,以及监测对治疗的反应。本研究将比较三种标志物降钙素原(PCT)、c反应蛋白(CRP)和胃泌素在诊断印度东部三级医院收治的疑似脓毒症患者中的作用。材料与方法:于2021年4月至2022年3月进行以医院为基础的横断面研究。从不同重症监护病房收治的有脓毒症证据的患者收集血液样本,并估计生物标志物。结果:3种生物标志物中,Presepsin的敏感性为89.1%,特异性为88.9%;PCT的敏感性为82.7%,特异性为80%;CRP的敏感性为74.5%,特异性为75.6%。presepsin的诊断准确率最高,其在受试者工作特征(ROC)曲线下的面积最高(0.858),其次是PCT,其在ROC曲线下的面积为0.793,其次是CRP,其在ROC曲线下的面积为0.741。结论:基于本研究结果,发现生物标志物是一种快速、简便、有效的脓毒症诊断方法,与PCT或CRP相比,presepsin被证明是最有希望诊断脓毒症的标志物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Sepsis Biomarkers: CRP, Procalcitonin, and Presepsin-Diagnostic and Prognostic Significance in Sepsis.

Background: Sepsis is undeniably a serious worldwide health threat, causing millions of deaths each year and a real diagnostic challenge to the clinicians. The conventional standard culture methods are often negative and time-consuming; therefore, alternatively specific and easily measurable biomarkers could help in predicting the diagnosis and prognosis of sepsis, as well as monitor the response to the treatments. This study will compare the role of the three markers procalcitonin (PCT), C-reactive protein (CRP), and presepsin in the diagnosis of sepsis in suspected patients admitted to a tertiary care hospital in eastern India.

Materials and methods: A hospital-based cross-sectional study was conducted from April 2021 to March 2022. Blood samples were collected from the patients admitted in various intensive care units with evidence of sepsis and the biomarkers were estimated.

Results: Presepsin was found to be the best among the three biomarkers with sensitivity 89.1% and specificity 88.9%, followed by PCT with sensitivity 82.7% and specificity 80%, and then CRP with sensitivity 74.5% and specificity 75.6%. The diagnostic accuracy of presepsin was also found to be maximum as its area under the receiver-operating characteristic (ROC) curve was highest (0.858) followed by PCT whose area under the ROC curve was 0.793, and then CRP with area under the ROC curve 0.741.

Conclusion: Based on the result of the present study, biomarkers were found to be quick, easy and effective test for diagnosing sepsis, and presepsin proved to be the most promising marker for diagnosis of sepsis as compared to PCT or CRP.

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