Zvyagin A A, Demidova V S, Smirnov G V
Vishnevsky National Medical Research Center for Surgery of Healthcare Ministry of Russia, Moscow, Russia.
Khirurgiia (Mosk). 2019(2):53-57. doi: 10.17116/hirurgia201902153.
To evaluate dynamics of presepsin, procalcitonin and C-reactive protein in survived and dead patients with sepsis.
There were 41 patients with diagnosis of 'sepsis' ('Sepsis-3' concept) who were divided into 2 groups: survived patients with sepsis (21 people) - group 1, dead patients with sepsis (20 people) - group 2. All patients underwent generally accepted intensive therapy for sepsis. Besides conventional laboratory and instrumental examination, dynamics of presepsin, procalcitonin and C-reactive protein was assessed.
Mean level of presepsin was 1718.00 and 3266.50 pg/ml in groups 1 and group 2, respectively. Half of the values was within (Me (25; 75) 1021.00-3231.00 pg/ml and 1618.50-7469.00 pg/ml in both groups, respectively. Mean level of procalcitonin was 0.995 and 4.465 ng/ml, respectively. Median (25; 75) was 0.49-4.44 ng/ml and 1,625-19.30 ng/ml, respectively. Mean level of C-reactive protein was 95.5 and 215.0 mg/L, respectively, median (25; 75) - 64.00-155.00 mg/L and 155.00-264.00 mg/L, respectively. Significant differences were determined for all variables (p-value 0.000008, 0.000242, 0.0000001 for presepsin, procalcitonin and C-reactive protein, respectively).
The levels of C-reactive protein, procalcitonin and presepsin were significantly different in patients with sepsis followed by favorable and unfavorable clinical outcome. Unfavorable outcome was associated with increased levels of all biomarkers. Comprehensive assessment of all biological markers of sepsis is useful to assess an effectiveness of intensive therapy and to predict clinical outcome.
评估脓毒症存活患者和死亡患者中可溶性髓系细胞触发受体-1（presepsin）、降钙素原和C反应蛋白的动态变化。
41例诊断为“脓毒症”（“脓毒症-3”概念）的患者被分为2组：脓毒症存活患者（21例）——第1组，脓毒症死亡患者（20例）——第2组。所有患者均接受了公认的脓毒症强化治疗。除常规实验室和仪器检查外，还评估了presepsin、降钙素原和C反应蛋白的动态变化。
第1组和第2组中presepsin的平均水平分别为1718.00和3266.50 pg/ml。两组中一半的值分别在（中位数（25%；75%））1021.00 - 3231.00 pg/ml和1618.50 - 7469.00 pg/ml范围内。降钙素原的平均水平分别为0.995和4.465 ng/ml。中位数（25%；75%）分别为0.49 - 4.44 ng/ml和1.625 - 19.30 ng/ml。C反应蛋白的平均水平分别为95.5和215.0 mg/L，中位数（25%；75%）分别为64.00 - 155.00 mg/L和155.00 - 264.00 mg/L。所有变量均存在显著差异（presepsin、降钙素原和C反应蛋白的p值分别为0.000008、0.000242、0.0000001）。
脓毒症患者中，C反应蛋白、降钙素原和presepsin的水平在临床结局良好和不良的患者中存在显著差异。不良结局与所有生物标志物水平升高有关。全面评估脓毒症的所有生物标志物有助于评估强化治疗的效果并预测临床结局。
