Higashikawa Toshihiro, Okuro Masashi, Ishigami Keiichirou, Mae Kunihiro, Sangen Ryusho, Mizuno Takurou, Usuda Daisuke, Saito Atushi, Kasamaki Yuji, Fukuda Akihiro, Saito Hitoshi, Morimoto Shigeto, Kanda Tsugiyasu
1 Kanazawa Medical University Himi Municipal Hospital, Saiwai-cho, Himi, Toyama, Japan.
2 Department of Geriatric Medicine, Kanazawa Medical University, Uchinada, Kahoku-gun, Ishikawa, Japan.
J Int Med Res. 2018 Jul;46(7):2606-2614. doi: 10.1177/0300060518766640. Epub 2018 Apr 16.
Aim This study was performed to investigate serum procalcitonin (PCT) and albumin (Alb) as prognostic biomarkers in elderly patients at risk of bacterial infection. Methods Serum PCT was measured in 270 hospitalized patients (mean age, 77.4 years) with suspected bacterial infection. The PCT-negative (<0.5 ng/mL) and PCT-positive (≥0.5 ng/mL) groups comprised 155 and 115 patients, respectively. Logistic regression analysis was performed with various clinical laboratory test values as independent variables and PCT positivity/negativity as the dependent variable. Results C-reactive protein (CRP) was the only independent variable significantly associated with PCT positivity/negativity. In the survival analysis, the 30-day in-hospital death rate was significantly higher in the PCT-positive than -negative group. Within the Alb-positive group (>2.5 g/dL), no significant difference in survival was observed between the PCT-positive and -negative groups. However, within the Alb-negative group (≤2.5 g/dL), the survival rate was significantly lower in the PCT-positive than -negative group. PCT was strongly associated with CRP and Alb, and having both PCT positivity and Alb negativity was a prognostic factor for elderly people at risk of bacterial infection. Conclusions Combined measurement of PCT with Alb is expected to be a valuable tool to assess prognosis in elderly people at risk of bacterial infection.
目的 本研究旨在探讨血清降钙素原（PCT）和白蛋白（Alb）作为有细菌感染风险的老年患者预后生物标志物的情况。方法 对270例疑似细菌感染的住院患者（平均年龄77.4岁）测定血清PCT。PCT阴性（<0.5 ng/mL）组和PCT阳性（≥0.5 ng/mL）组分别有155例和115例患者。以各种临床实验室检查值作为自变量，PCT阳性/阴性作为因变量进行逻辑回归分析。结果 C反应蛋白（CRP）是与PCT阳性/阴性显著相关的唯一自变量。在生存分析中，PCT阳性组的30天住院死亡率显著高于阴性组。在白蛋白阳性组（>2.5 g/dL）中，PCT阳性组和阴性组的生存率无显著差异。然而，在白蛋白阴性组（≤2.5 g/dL）中，PCT阳性组的生存率显著低于阴性组。PCT与CRP和Alb密切相关，PCT阳性且Alb阴性是有细菌感染风险老年人的一个预后因素。结论 PCT与Alb联合检测有望成为评估有细菌感染风险老年人预后的有价值工具。
