应用血浆 Presepsin、C 反应蛋白、降钙素原和肾上腺髓质原肽预测儿童血液系统恶性肿瘤中性粒细胞减少伴发热患者的菌血症。

Usage of Plasma Presepsin, C-Reactive Protein, Procalcitonin and Proadrenomedullin to Predict Bacteremia in Febril Neutropenia of Pediatric Hematological Malignancy Patients.

机构信息

Health Sciences University, Izmir Behcet Uz Children's Hospital, Department of Pediatric Infectious Diseases, Izmir, Turkey.

Health Sciences University, Izmir Tepecik Research and Training Hospital, Department of Pediatric Infectious Diseases, Izmir, Turkey.

出版信息

Lab Med. 2021 Sep 1;52(5):477-484. doi: 10.1093/labmed/lmab002.

DOI:10.1093/labmed/lmab002

PMID:33851202

Abstract

OBJECTIVE

To investigate the value of presepsin and proadrenomedullin (proADM) as new markers for febrile neutropenia, by comparing them with conventional markers.

METHODS

Plasma specimens for presepsin, proADM, C-reactive protein (CRP), and procalcitonin (PCT) were collected every 3 days during each episode of febrile neutropenia.

RESULTS

A total of 39 patients experiencing a collective 47 episodes of febrile neutropenia with hematological malignant neoplasms, as well as 40 healthy control patients without infectious disease, were enrolled in this study. Levels of the studied analytes in the presepsin 1 group (with baseline values taken at admission), presepsin 2 group (values recorded on the 3rd day of febrile neutropenia), and presepsin 3 group (values recorded on the 6th day of hospitalization) were all higher in the subgroups with bacteremia. C-reactive protein 1 (baseline value taken at admission), procalcitonin 1 (as recorded at admission), and procalcitonin 2 (recorded on the 3rd day of febrile neutropenia) were higher in the subroups with bacteremia (P =.03, P = .04, and P = .04, respectively). In multivariate logistic regression analysis, presepsin 1 and/or PCT 1/CRP 1 combined analysis was superior in predicting bacteremia.

CONCLUSION

Presepsin could be used in combination with other biomarkers to detect bacteremia.

摘要

目的

通过与常规标志物比较，探讨降钙素原前肽（presepsin）和前肾上腺髓质素（proadrenomedullin，proADM）作为发热性中性粒细胞减少症新标志物的价值。

方法

在每次发热性中性粒细胞减少症发作期间，每 3 天采集血浆标本用于检测降钙素原前肽、前肾上腺髓质素、C 反应蛋白（CRP）和降钙素原（PCT）。

结果

本研究共纳入 39 例患有血液恶性肿瘤且发生发热性中性粒细胞减少症的患者（共 47 例次）和 40 例无感染性疾病的健康对照患者。在基线值（入院时）、发热性中性粒细胞减少症第 3 天（第 2 组）和第 6 天（第 3 组）采集的降钙素原前肽 1 组、降钙素原前肽 2 组和降钙素前肽 3 组中，菌血症亚组的研究分析物水平均较高。在 C 反应蛋白 1 组（入院时的基线值）、降钙素原 1 组（入院时记录）和降钙素原 2 组（发热性中性粒细胞减少症第 3 天记录）中，菌血症亚组的水平更高（分别为 P =.03、P =.04 和 P =.04）。在多变量逻辑回归分析中，降钙素原前肽 1 和/或 PCT 1/CRP 1 联合分析在预测菌血症方面更具优势。