【摘要】 目的探讨可溶性CD14亚型(sCD14-ST,Presepsin)与血培养结果的关系和对脓毒症的预测价值。方法以血培养结果将样本分成脓毒症组和非脓毒症组。同时检测血清降钙素原(PCT)、C反应蛋白(CRP)和Presepsin浓度,使用统计学方法比较Presepsin、降钙素原、C反应蛋白与血培养结果的符合率及正确性。结果Presepsin、PCT、CRP与血培养比较,Kappa值分别为0.835、0.612、0.412。ROC曲线结果显示:Presepsin的ROC曲线下面积为0.970,界值为546pg/mL时,灵敏度为82.0%;特异性为98.1%;准确性94.0%;PCT的ROC曲线下面积为0.908,界值为1.02μg/L时,灵敏度为77.5%;特异性为86.9%;准确性84.5%;CRP的ROC曲线下面积为0.797,界值为48.7mg/ml时,灵敏度为66.3%;特异性为78.8%;准确性75.6%。结论血清Presepsin水平与血培养结果高度相关,在诊断脓毒症的准确性方面优于降钙素原和C反应蛋白,可作为诊断脓毒症的早期指标。更多还原

【Abstract】 Objective To investigate the relationship between soluble CD14 subtype(sCD14-ST,Presepsin)and blood culture results and the predictive value for sepsis.Methods The samples were divided into sepsis group and nonsepsis group in accordance with blood culture results.Serum procalcitonin(PCT),C-reactive protein(CRP)and Presepsin concentrations were also measured.Statistical methods were used to compare the coincidence and correctness of Presepsin,procalcitonin,C-reactive protein and blood culture results.Results Compared with blood culture,Presepsin,PCT and CRP the Kappa values were 0.835,0.612 and 0.412,respectively.The results of ROC curve showed that the area under the ROC curve of Presepsin was 0.970,the cutoff value was 546 pg/mL,the sensitivity was 82.0%,the specificity was 98.1%,the accuracy was 94.0%,and the area under the ROC curve of PCT was 0.908 with a cutoff value of 1.02μg/L,sensitivity is 77.5%,specificity is 86.9%,accuracy is 84.5%.CRP has an ROC curve area of 0.797,a cutoff value of 48.7 mg/ml,a sensitivity of 66.3%,and a specificity of 78.8%and 75.6%respectively.Conclusion Serum Presepsin level is highly correlated with blood culture results and may be superior to procalcitonin and CRP in the diagnosis of sepsis.It can be used as an early indicator for the diagnosis of sepsis.更多还原