血清蛋白酶在脓毒症患者革兰氏阴性菌与革兰氏阳性菌及真菌感染鉴别中的价值

Q4 Nursing

中华急诊医学杂志 Pub Date : 2019-10-10 DOI:10.3760/CMA.J.ISSN.1671-0282.2019.10.023

Zhihui Ye, Hongguang Ding, Jingkun Ye, Gengxin Cai, Hongke Zeng, Miaoyun Wen

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引用次数: 0

摘要

目的探讨presepsin水平是否可作为脓毒症患者G-菌和G+菌真菌感染的鉴别指标。方法对2017年6月至2018年11月连续入住重症监护病房(ICU)的细菌培养阳性患者进行前瞻性观察研究。将患者分为G-组、G+组和真菌组。入院时采集血液样本，测量高血压素和降钙素原(PCT)水平。结果(1)156例患者符合纳入标准。检出G-棒状菌96株(62%)，G+菌25株(16%)，真菌35株(22%)。(2) G-组Presepsin浓度显著高于G+和真菌组(P = 0.000)。(3) Presepsin水平对G-脓毒症与Gram+、真菌脓毒症的鉴别准确率高于PCT水平[曲线下面积(AUC): 0.809 vs 0.712]。在G-脓毒症与Gram+及真菌性脓毒症的鉴别中，presepsin与PCT联合使用的AUC值明显大于单独使用presepsin的AUC值(AUC: 0.866 vs 0.809)。结论与PCT相比，presepsin是一种很好的区分不同感染的生物标志物。关键词:脓毒症;Presepsin;原降钙素;感染

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The value of serum presepsin in differentiating Gram-negative bacteria from Gram-positive bacteria and fungal infection in sepsis patients

Objective To examine whether presepsin level can serve as a distinguishing marker between G- bacteria and G+ bacteria, fungal infection in sepsis patients. Methods A prospective observation study was conducted on the consecutive patients with positive bacterial cultures in intensive care unit (ICU) from June 2017 to November 2018. The patients were divided into the G- group, G+ group and fungal group. Blood samples were collected upon admission to measure the levels of presepsin and procalcitonin (PCT). Results (1) Of the 156 patients met the inclusion criteria. 96 (62% G- rods, 25 (16%) G+ microbes, and 35 (22%) fungi were detected. (2) Presepsin concentrations were significantly higher in the G- group compared with the G+ and fungal groups (P = 0.000). (3) Presepsin level has a higher accuracy in differentiating G- sepsis from Gram+ and fungal sepsis than PCT level [area under the curve (AUC): 0.809 vs 0.712]. The AUC value of a combination of presepsin and PCT level was significantly larger than that of presepsin level alone in differentiating G- sepsis from Gram+ and fungal sepsis (AUC: 0.866 vs 0.809). Conclusions In contrast to PCT, presepsin is a good discriminative biomarker in different infections. Key words: Sepsis; Presepsin; Procalcitonin; Infection

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来源期刊

中华急诊医学杂志 Nursing-Emergency Nursing

CiteScore

0.10

自引率

0.00%

发文量

8629

期刊介绍： Chinese Journal of Emergency Medicine is the only national journal which represents the development of emergency medicine in China. The journal is supervised by China Association of Science and Technology, sponsored by Chinese Medical Association, and co-sponsored by Zhejiang University. The journal publishes original research articles dealing with all aspects of clinical practice and research in emergency medicine. The columns include Pre-Hospital Rescue, Emergency Care, Trauma, Resuscitation, Poisoning, Disaster Medicine, Continuing Education, etc. It has a wide coverage in China, and builds up communication with Hong Kong, Macao, Taiwan and international emergency medicine circles.