Cakır Madenci Özlem, Yakupoğlu Sezer, Benzonana Nur, Yücel Nihal, Akbaba Derya, Orçun Kaptanağası Asuman
Dr. Lütfi Kırdar Kartal Research and Training Hospital, Biochemistry Laboratory, İstanbul, Turkey.
Dr. Lütfi Kırdar Kartal Research and Training Hospital, Burn Center Anaesthesia and Reanimation Clinic, Turkey.
Burns. 2014 Jun;40(4):664-9. doi: 10.1016/j.burns.2013.08.024. Epub 2013 Sep 26.
Diagnosing sepsis is difficult in burn patients because of the inflammatory mediators that alter postburn metabolic profile. Here, we compare a new marker presepsin with procalcitonin (PCT), c-reactive protein (CRP) and white blood cell (WBC) in diagnosis and follow up of sepsis in burn patients.
Patients admitted to burn center of our institute were prospectively investigated. Presepsin, PCT, CRP and WBC levels were measured at admission and every 6h for first day and daily thereafter. At all timing samples, patients were classified as sepsis or non-sepsis according to the current American Burn Association Consensus Criteria (ABA) 2007.
37 adult patients were evaluated. A total data of 611 time points were supplied. Sepsis time points differ significantly from non-sepsis in presepsin (p < 0.0001), PCT (p = 0.0012) and CRP (p < 0.0001) levels. Non-surviving patient results differ significantly from survivors in presepsin (p < 0.0001), PCT (p = 0.0210) and CRP (p = 0.0008). AUC-ROC % values for diagnosing sepsis were 83.4% for presepsin, 84.7% for PCT, 81.9% for CRP and 50.8% for WBC. Sepsis patients had significantly different presepsin, CRP and WBC but not PCT levels on their first day of sepsis compared to previous days.
Plasma presepsin levels have comparable performance in burn sepsis.
由于炎症介质会改变烧伤后的代谢状况，烧伤患者的脓毒症诊断较为困难。在此，我们比较一种新的标志物可溶性髓系细胞触发受体-1（presepsin）与降钙素原（PCT）、C反应蛋白（CRP）和白细胞（WBC）在烧伤患者脓毒症诊断及随访中的作用。
对我院烧伤中心收治的患者进行前瞻性研究。入院时及入院后第一天每6小时、之后每天检测presepsin、PCT、CRP和WBC水平。在所有时间点的样本中，根据2007年美国烧伤协会共识标准（ABA）将患者分为脓毒症组或非脓毒症组。
对37例成年患者进行了评估。共提供了611个时间点的全部数据。脓毒症时间点的presepsin（p < 0.0001）、PCT（p = 0.0012）和CRP（p < 0.0001）水平与非脓毒症组有显著差异。非存活患者的presepsin（p < 0.0001）、PCT（p = 0.0210）和CRP（p = 0.0008）结果与存活患者有显著差异。诊断脓毒症的曲线下面积（AUC-ROC）百分比值，presepsin为83.4%，PCT为84.7%，CRP为81.9%，WBC为50.8%。脓毒症患者在脓毒症第一天的presepsin、CRP和WBC水平与前几天相比有显著差异，但PCT水平无差异。
血浆presepsin水平在烧伤脓毒症诊断中具有相当的性能。
