Hoshino K, Irie Y, Mizunuma M, Kawano K, Kitamura T, Ishikura H
Anaesth Intensive Care. 2017 Sep;45(5):600-604. doi: 10.1177/0310057X1704500510.
Procalcitonin (PCT) and presepsin (PSEP) are useful biomarkers for diagnosing sepsis; however, elevated PCT and PSEP levels may be observed in conditions other than sepsis. We hypothesised that PCT and PSEP levels could increase after severe traumatic injuries. Trauma patients with an Injury Severity Score of ≥16 from October 2013 to September 2015 were enrolled in our study. We examined PCT and PSEP levels and their positive rates on days 0 and 1. PCT and PSEP levels on days 0 and 1 were compared. Risk factors for increasing sepsis biomarker levels were identified by multivariate logistic regression analyses. In this study, 75 patients were included. PCT levels on days 0 and 1 were 0.1±0.4 and 1.8±6.3 ng/ml, respectively (=0.02). PSEP levels on days 0 and 1 were 221±261 and 222±207 pg/ml, respectively (=0.98). As per multivariate logistic regression analyses, packed red blood cell (PRBC) transfusion was the only independent risk factor for higher PCT levels on day 1 (=0.04). Using PCT to diagnose sepsis in trauma patients on day 1 requires caution. PRBC transfusion was found to be a risk factor for increasing PCT levels. On the other hand, PSEP levels were not affected by trauma during the early phases.
降钙素原（PCT）和可溶性髓系细胞触发受体-1（PSEP）是诊断脓毒症的有用生物标志物；然而，在脓毒症以外的其他情况下也可能观察到PCT和PSEP水平升高。我们假设严重创伤后PCT和PSEP水平可能会升高。2013年10月至2015年9月损伤严重程度评分≥16分的创伤患者纳入本研究。我们检测了第0天和第1天的PCT和PSEP水平及其阳性率。比较了第0天和第1天的PCT和PSEP水平。通过多因素逻辑回归分析确定脓毒症生物标志物水平升高的危险因素。本研究共纳入75例患者。第0天和第1天的PCT水平分别为0.1±0.4和1.8±6.3 ng/ml（P=0.02）。第0天和第1天的PSEP水平分别为221±261和222±207 pg/ml（P=0.98）。根据多因素逻辑回归分析，输注浓缩红细胞（PRBC）是第1天PCT水平升高的唯一独立危险因素（P=0.04）。在第1天使用PCT诊断创伤患者的脓毒症时需谨慎。发现输注PRBC是PCT水平升高的一个危险因素。另一方面，早期PSEP水平不受创伤影响。
