Khater Walaa S, Salah-Eldeen Noha N, Khater Mohamed S, Saleh Asghraf N
Medical Microbiology and Immunology Department, Faculty of Medicine, Ain Shams University , Cairo, Egypt.
Geriatrics and Gerontology Department, Faculty of Medicine, Ain Shams University , Cairo, Egypt.
Eur J Microbiol Immunol (Bp). 2016 Jul 19;6(3):178-185. doi: 10.1556/1886.2016.00011. eCollection 2016 Sep 29.
This study investigated the diagnostic value of soluble urokinase plasminogen activator receptor (suPAR) and serum lactate in elderly patients with sepsis and evaluated their capacity to predict mortality and their correlation to Sequential Organ Failure Assessment (SOFA) score. The study included 80 participants, divided into two groups: 40 cases (mean age, 68.9 ± 5.9) admitted to the intensive care unit and 40 healthy controls (mean age, 67.1 ± 6.2). Elderly patients with sepsis had significantly higher levels of serum suPAR and lactic acid compared to healthy controls. Receiver operating characteristic (ROC) curve analysis showed that suPAR (cutoff value, ≥4.37 ng/ml) has higher area under the curve (AUC) than lactic acid (cutoff value, ≥1.95 mmol/l) for diagnosing sepsis. Serum lactate has superior prognostic value compared to suPAR with AUC of 0.82 (cutoff value, 2.2 mmol/l) and 0.72 (cutoff value, 6.3 ng/ml), respectively. The diagnostic power of combined usage of suPAR and lactate serum concentrations showed AUC of 0.988 (95% confidence interval 0.934 to 1.0). The combination of both biomarkers either together or with SOFA score may serve as a useful guide to patients who need more intensive resuscitation.
本研究调查了可溶性尿激酶型纤溶酶原激活物受体（suPAR）和血清乳酸对老年脓毒症患者的诊断价值，并评估了它们预测死亡率的能力以及与序贯器官衰竭评估（SOFA）评分的相关性。该研究纳入了80名参与者，分为两组：40例入住重症监护病房的患者（平均年龄68.9±5.9岁）和40名健康对照者（平均年龄67.1±6.2岁）。与健康对照者相比，老年脓毒症患者的血清suPAR和乳酸水平显著更高。受试者工作特征（ROC）曲线分析显示，对于脓毒症的诊断，suPAR（临界值≥4.37 ng/ml）的曲线下面积（AUC）高于乳酸（临界值≥1.95 mmol/l）。血清乳酸的预后价值优于suPAR，其AUC分别为0.82（临界值2.2 mmol/l）和0.72（临界值6.3 ng/ml）。联合使用suPAR和乳酸血清浓度的诊断效能显示AUC为0.988（95%置信区间0.934至1.0）。这两种生物标志物单独或与SOFA评分联合使用，可能为需要更强化复苏的患者提供有用的指导。
