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降钙素原血清水平在鉴别严重脓毒症与脓毒症中的应用:一项多中心前瞻性研究。

Usefulness of procalcitonin serum level for the discrimination of severe sepsis from sepsis: a multicenter prospective study.

作者信息

Endo Shigeatsu, Aikawa Naoki, Fujishima Seitaro, Sekine Isao, Kogawa Kazuhiro, Yamamoto Yasuhiro, Kushimoto Shigeki, Yukioka Hidekazu, Kato Noboru, Totsuka Kyoichi, Kikuchi Ken, Ikeda Toshiaki, Ikeda Kazumi, Yamada Hiroyuki, Harada Kazuaki, Satomura Shinji

机构信息

Critical Care and Emergency Center, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan.

出版信息

J Infect Chemother. 2008 Jun;14(3):244-9. doi: 10.1007/s10156-008-0608-1. Epub 2008 Jun 24.

Abstract

Procalcitonin serum level has been recommended as a new marker of bacterial infectious diseases. The aim of this prospective, multicenter study was to determine the clinical usefulness of procalcitonin in differentiating patients with sepsis from those with severe sepsis. Eighty-two patients were enrolled: 20 without systemic inflammatory response syndrome (SIRS), 9 with SIRS, 34 with sepsis, and 19 with severe sepsis. The patients with severe sepsis had significantly higher procalcitonin levels (median, 36.1 ng/ml) than those with sepsis (median, 0.6 ng/ml). With a procalcitonin cutoff value of 2.0 ng/ml, sensitivity for the detection of severe sepsis and specificity for the detection of sepsis were 94.7% and 78.1%, respectively. A good correlation was found between the serum procalcitonin level and the Sepsis-Related Organ Failure Assessment (SOFA) score (r = 0.680), although no correlation was found between the C-reactive protein (CRP) level and the SOFA score. In conclusion, the procalcitonin serum level may be useful not only for aiding the diagnosis of sepsis but also for discriminating between sepsis and severe sepsis.

摘要

血清降钙素原水平已被推荐作为细菌性传染病的一种新标志物。这项前瞻性多中心研究的目的是确定降钙素原在区分脓毒症患者和严重脓毒症患者方面的临床实用性。共纳入82例患者:20例无全身炎症反应综合征(SIRS),9例有SIRS,34例有脓毒症,19例有严重脓毒症。严重脓毒症患者的降钙素原水平(中位数,36.1 ng/ml)显著高于脓毒症患者(中位数,0.6 ng/ml)。降钙素原临界值为2.0 ng/ml时,检测严重脓毒症的灵敏度和检测脓毒症的特异度分别为94.7%和78.1%。血清降钙素原水平与脓毒症相关器官功能障碍评估(SOFA)评分之间存在良好的相关性(r = 0.680),而C反应蛋白(CRP)水平与SOFA评分之间未发现相关性。总之,血清降钙素原水平不仅可能有助于脓毒症的诊断,还可用于区分脓毒症和严重脓毒症。

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