Am J Med Sci:可溶性CD14-A——评估重症脓毒症患者预后的新型生物标记物

2017-07-30 MedSci MedSci原创

本实验旨在评估与血清降钙素原和C-反应蛋白相比,presepsin(可溶性CD14亚型,sCD14 ST)对预测重症脓毒症患者预后的作用。

本实验旨在评估与血清降钙素原和C-反应蛋白相比,presepsin(可溶性CD14亚型,sCD14-ST)对预测重症脓毒症患者预后的作用。

本研究是一项观察性前瞻性研究,共纳入了58名内外科ICU收治的疑似脓毒症患者。基于28天生存率和血培养阳性或阴性的结果,对所有研究对象回顾性分为死亡组和生存组。分别抽取每位患者在刚入院时(T-0)、入院后24-48小时(T-1)、入院后7天(T-2)的血浆和血清样本。使用Student's t检验和单因素方差分析进行统计,使用Bonferroni进行事后检验,同时进行ROC曲线分析。

死亡组患者在T-0(P=0.0007)、T-1(P<0.0001)、T-2(P<0.0001)时间点测得的presepsin水平明显较死亡者同一时间点的presepsin水平高。血培养阳性患者在T-0(P=0.0073)、T-1(P=0.0111)、T-2(P=0.0167)测得的presepsin浓度同样明显较血培养阴性患者同一时间点的presepsin浓度高。对所有的时间段进行数据评估,对死亡和生存的患者分别进行ROC分析,表现出了良好的精确度和显著的ROC曲线下面积(P<0.0001)。对研究结果进行多因素分析显示,presepsin可作为在T-0时对脓毒症预测的独立变量(P=0.016)。

由此我们可以得出结论,presepsin可能成为重症脓毒症患者诊断的最佳手段,对诊断脓毒症有极高的价值。预测危重脓毒症患者的预后对优化疾病管理决策和治疗手段起到至关重要的作用。

原始出处:

Matera G1, Quirino A2, et al. Soluble CD14 Subtype-A New Biomarker in Predicting the Outcome of Critically Ill Septic Patients. Am J Med Sci. 2017 Jun;353(6):543-551. doi: 10.1016/j.amjms.2017.03.036. Epub 2017 Apr 7.

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    2018-06-05 一叶知秋
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    2017-10-30 wjywjy
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  8. 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encodeId=259022805839, content=henhao, beContent=null, objectType=article, channel=null, level=null, likeNumber=1, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NcXNhUvfhzd2VdicMnaLeK2Im5gKx4Ucxd8Bwu6S7RG0uILBFQx5HTW2bU4VricDYlQqN20ibASSMYAeGrZrrTpy2Q/0, createdBy=b0041939716, createdName=hhh678, createdTime=Sun Jul 30 13:16:15 CST 2017, time=2017-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=228037, encodeId=b99722803e9a, content=问题是这个指标有什么病理生理意义,是怎么筛选出来的, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/07/22/e7da3674e22afa945542edd05cf44d56.jpg, createdBy=14a72022310, createdName=明天之医, createdTime=Sun Jul 30 11:29:20 CST 2017, time=2017-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=228031, encodeId=a03522803172, content=签到学习了很多。, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/A3E53E62691178E2F18D7B999FD22131/100, createdBy=f44d2003846, createdName=Chongyang Zhang, createdTime=Sun Jul 30 11:19:48 CST 2017, time=2017-07-30, status=1, ipAttribution=)]
    2017-07-30 hhh678

    henhao

    0

  9. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=228031, encodeId=a03522803172, content=签到学习了很多。, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/A3E53E62691178E2F18D7B999FD22131/100, createdBy=f44d2003846, createdName=Chongyang Zhang, createdTime=Sun Jul 30 11:19:48 CST 2017, time=2017-07-30, status=1, ipAttribution=)]
    2017-07-30 明天之医

    问题是这个指标有什么病理生理意义,是怎么筛选出来的

    0

  10. 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encodeId=259022805839, content=henhao, beContent=null, objectType=article, channel=null, level=null, likeNumber=1, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NcXNhUvfhzd2VdicMnaLeK2Im5gKx4Ucxd8Bwu6S7RG0uILBFQx5HTW2bU4VricDYlQqN20ibASSMYAeGrZrrTpy2Q/0, createdBy=b0041939716, createdName=hhh678, createdTime=Sun Jul 30 13:16:15 CST 2017, time=2017-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=228037, encodeId=b99722803e9a, content=问题是这个指标有什么病理生理意义,是怎么筛选出来的, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/07/22/e7da3674e22afa945542edd05cf44d56.jpg, createdBy=14a72022310, createdName=明天之医, createdTime=Sun Jul 30 11:29:20 CST 2017, time=2017-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=228031, encodeId=a03522803172, content=签到学习了很多。, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/A3E53E62691178E2F18D7B999FD22131/100, createdBy=f44d2003846, createdName=Chongyang Zhang, createdTime=Sun Jul 30 11:19:48 CST 2017, time=2017-07-30, status=1, ipAttribution=)]
    2017-07-30 Chongyang Zhang

    签到学习了很多。

    0