Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si, Gyeonggi-do, Republic of Korea.
Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Int J Infect Dis. 2020 Aug;97:260-266. doi: 10.1016/j.ijid.2020.05.105. Epub 2020 Jun 1.
Related innate immune system activation and diagnostic factors of sepsis are not fully understood. The aim of this study was to analyze the clinical value of full-length tryptophanyl-tRNA synthetase (WRS) induced through inflammatory stimuli for the detection of sepsis and prediction of mortality in critically ill patients.
This was a retrospective analysis of blood samples collected prospectively from patients in the medical intensive care unit (ICU) at Yonsei University College of Medicine, from March 2015 to June 2018. The ability of WRS to detect sepsis and predict mortality were compared to those of procalcitonin (PCT), C-reactive protein (CRP), and interleukin 6 (IL-6), and with Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores.
A total of 241 study patients were enrolled, of whom 190 (78.8%) had been diagnosed with sepsis on ICU admission. The areas under the receiver operating characteristics curves (AUROCs) for sepsis discrimination with WRS, PCT, CRP, and IL-6 levels, and SOFA and APACHE II scores were 0.864, 0.727, 0.625, 0.651, 0.840, and 0.754, respectively. The prediction of 28-day mortality in patients with sepsis using WRS levels was possible and non-inferior to that with the SOFA score.
WRS secreted early in sepsis may be useful not only for the early detection of sepsis, but also for the prediction of mortality in critically ill patients.
人们对与先天免疫系统激活相关的以及败血症的诊断因素仍了解不充分。本研究旨在分析通过炎症刺激诱导的全长色氨酰-tRNA 合成酶（WRS）在检测败血症和预测危重症患者死亡率方面的临床价值。
这是一项回顾性分析，对 2015 年 3 月至 2018 年 6 月期间在延世大学医学院内科重症监护病房（ICU）前瞻性采集的血液样本进行分析。比较 WRS 对败血症的检测能力和对死亡率的预测能力与降钙素原（PCT）、C 反应蛋白（CRP）和白细胞介素 6（IL-6）以及序贯器官衰竭评估（SOFA）和急性生理学和慢性健康评估 II（APACHE II）评分的检测能力。
共纳入 241 例研究患者，其中 190 例（78.8%）在 ICU 入住时被诊断为败血症。WRS、PCT、CRP 和 IL-6 水平以及 SOFA 和 APACHE II 评分对败血症的鉴别诊断的受试者工作特征曲线下面积（AUROCs）分别为 0.864、0.727、0.625、0.651、0.840 和 0.754。WRS 水平对败血症患者 28 天死亡率的预测与 SOFA 评分相当。
败血症早期分泌的 WRS 不仅有助于早期检测败血症，而且有助于预测危重症患者的死亡率。
