Clinical significance of presepsin(sCD14-ST)for diagnosis, severity evaluation and prognostic prediction of acute infections in elderly patients
10.3760/cma.j.issn.0254-9026.2019.03.006
- VernacularTitle:白细胞分化抗原14亚型在老年急性感染患者诊断和预后评价中的作用
- Author:
Jinghua QUAN
1
;
Xinchao ZHANG
;
Hongxia WANG
Author Information
1. 北京医院急诊科
- Keywords:
Differentiation antigens;
leukocyte;
Spsis;
Diagnosis;
Prognosis
- From:
Chinese Journal of Geriatrics
2019;38(3):246-250
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate clinical significance of soluble CD14 subtype presepsin for diagnosing,evaluating severity and predicting prognosis of acute infections in elderly patients.Methods Sixty elderly emergency patients without acute infections as control and 117 elderly emergency patients with acute infections were enrolled.Patients with infections were divided into the systemicinflamatory response syndrome(SIRS) (infection+ SIRS group,n =59),sepsis group (n =41)and septic shock group(n=17),and were further divided into survival group(n=90)and death group (n=27)according to 30-day mortality.Serum levels of presepsin and procalcitonin (PCT)were measured by using enzyme-linked immunosorbent assay(ELISA)within 24 hours after doctors' office visiting.The mortality in emergency department sepsis(MEDS) scores was evaluated.Clinical value and correlations of presepsin and PCT in diagnosis,disease evaluation and prognosis evaluation were compared and analyzed Results Presepsin level was higher in acute infection group than in no-infection group[734.0(422.5,1120.0) ng/L vs.159.50 (119.0,234.3) ng/L,P ＜0.05].Presepsin level was 423.0(266.3,554.0)ng/L in infection+SIRS group,1042.0(854.0,1213.0)ng/L in sepsis group,and 2188.0(1599.5,2946.0) ng/L in septic shock group,with statistically significant differences among infection+SIRS group,sepsis group and septic shock group(P ＜0.05).No significant differences in PCT levels were found between sepsis group and septic shock group[4.4(1.4,16.9)ng/L,vs.8.8 (0.7,51.1)ng/L,P＞0.05].MEDS had no difference between sepsis group and septic shock group [(13.0(11.0,17.5) vs.15.0 (11.5,19.5),P ＞ 0.05].There were significant differences in serum levels of presepsin(554.0ng/L vs.1232.5 ng/L),PCT(1.18 μg/L vs.10.07 μg/L) and MEDS(9.0 vs.18.0)between the survival group and the death group(P＜0.05),and their area under a receiver operating characteristic(ROC) curve was (0.853 ± 0.037),(0.732 ± 0.057) and (0.900 ± 0.034)respectively.Serum level of presepsin was moderately correlated with MEDS(r =0.609,P =0.00)and lowly correlated with PCT(r =0.477,P =0.00).Conclusions Presepsin is a good biomarker for acute infection,which has better clinical value for diagnosis,severity evaluation and prognostic prediction of acute infections in elderly patients.
