Clinical significance of sCD14-ST in early diagnosis of children sepsis
10.3760/cma.j.issn.1009-9158.2016.04.005
- VernacularTitle:sCD14－ST在儿童脓毒症早期诊断中的应用
- Author:
Ting XIAO
;
Liping CHEN
;
Xiaohua HUANG
;
Hui LIU
;
Yuan CHEN
;
Dingchang WU
- Publication Type:Journal Article
- Keywords:
Sepsis;
Child;
Systemic inflammatory response syndrome;
Antigens,differentiation;
Case-control studies
- From:
Chinese Journal of Laboratory Medicine
2016;39(4):251-255
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical significance of sCD14-ST in diagnosing children sepsis and monitoring the treatment effects. Methods Case-control study. Patients were recruited by Longyan First Hospital from August 2013 to March 2015.The sCD14-ST, WBC, CRP, PCT and APACHE-Ⅱlevels were measured in 237 septic children ( infectious SIRS, including 120 bacterial and 117 nonbacterial SIRS) , 89 non-infectious SIRS and 156 healthy children.The changes and the correlation of the five indicators in septic children before and after treatment was compared.The diagnosis value of sCD14-ST in sepsis by the receiver operationg characteristic curves ( ROC) was analyzed.Results The sCD14-ST level in septic children [643.47(596.47 -690.46) ng/L] was higher than that in non-infectious SIRS [246.94(234.85-259.03)ng/L]and healthy control [151.00(142.79-159.22)ng/L](χ2 =121.850, 325.663, P<0.01).The whole blood level of sCD14-ST in bacterial sepsis [606.17(542.71-669.63) ng/L]and non-bacterial sepsis [679.83(610.37-747.29)ng/L]were no significance (χ2 =0.854, P=0.335), while compared with the control group, they had significant differences (χ2 =326.228, P<0.01) .Totally 80 blood culture samples were positive in 117 bacterial septic children, and the sCD14-ST level was not significant between Gram positive bacteria infection and [641.07 (553.82 -728.31) ng/L] Gram negative bacteria infection[750.00(597.10 -902.89) ng/L] (χ2 =1.12,P=0.29), but the sCD14-ST level in blood culture positive children was significantly higher than healthy controls ( chi-square =117. 46, 155.846, P<0.01).sCD14-ST, WBC, CRP, PCT, APACHE-Ⅱscore before and after treatment were all significantly decreased ( χ2 =44.569, 113.337, 63.986, 100.055, 51.015, P<0.01).The sCD14-ST was significantly positively related withCRP and APACHE-Ⅱ score before treatment, but there were no correlation with WBC and PCT.The ROC-AUC of sCD14-ST in septic children was 0.901.Compared with the ROC-AUCs of WBC ( 0.875 ) and CRP ( 0.836 ) , there were statistically significant different ( P<0.01).The sensitivity and specificity of sCD14-ST were 85%, 90%, respectively.Conclusions The study suggested that sCD14-ST superior value to the diagnosis of sepsis in children than other parameters.It should be applied as a valuable biomarker for early diagnosis and the evaluation of severity of sepsis.
