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降钙素原可否成为 COVID-19 脓毒症早期诊断的替代标志物?

Could presepsin be an alternative marker in the early diagnosis of sepsis in COVID-19?

机构信息

Department of Tissue Typing Laboratory, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey.

Department of Medical Biochemistry, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey.

出版信息

Scand J Clin Lab Invest. 2022 Apr;82(2):108-114. doi: 10.1080/00365513.2022.2031278. Epub 2022 Feb 1.

Abstract

In critical patients with Coronavirus Disease (COVID-19), we investigated the diagnostic value of presepsin in the early diagnosis of superinfection with sepsis, and the effect of antibiotic treatment (AT) in the levels of presepsin and procalcitonin and C-reactive protein. A total of 68 critical patients with sepsis and septic shock in the intensive care unit and 20 outpatients (control group) with COVID-19 were taken. ICU patients ( = 68) were further divided into three groups. C(-)AT(-) had negative blood or tracheal aspirate cultures (C) and not AT on admission to ICU ( = 18), C(-)AT(+) had negative C and AT on admission to intensive care unit ( = 31) and C(+) had positive C ( = 19). Presepsin, procalcitonin, C-reactive protein results were compared between the groups. There were no significant relationships between presepsin levels with sepsis, septic shock, mortality, or length of stay in ICU in patients with COVID-19. For procalcitonin and C-reactive protein levels in C(-)AT(+) and C(+) groups were significantly higher than in control and C(-)AT(-) groups ( < .001). C-reactive protein levels in C(-)AT(-) group were significantly higher than in the control group ( < .001). PCT and CRP, there was no difference between C(-)AT(+) and C(+) groups, and procalcitonin there was no difference between control and C(-)AT(-) groups. Presepsin was not found as a useful biomarker for the prediction of sepsis in COVID-19 patients. These study findings indicate that procalcitonin and C-reactive protein may be an indicator of an early diagnostic marker for superinfection in critical COVID-19 patients.

摘要

在患有冠状病毒病 (COVID-19) 的危重症患者中,我们研究了降钙素原前体 (presepsin) 在早期诊断继发感染性败血症中的诊断价值,以及抗生素治疗 (AT) 对 presepsin 和降钙素原及 C 反应蛋白水平的影响。共纳入重症监护病房中患有败血症和败血症性休克的 68 例危重症患者和 20 例门诊 COVID-19 患者(对照组)。将 ICU 患者( = 68)进一步分为三组:C(-)AT(-) 组血或气管抽吸培养均为阴性 (C),且入 ICU 时无 AT( = 18),C(-)AT(+) 组 C 为阴性且入 ICU 时给予 AT( = 31),C(+) 组 C 为阳性( = 19)。比较各组间 presepsin、降钙素原、C 反应蛋白结果。COVID-19 患者中,presepsin 水平与败血症、败血症性休克、死亡率或 ICU 住院时间无显著关系。与对照组和 C(-)AT(-) 组相比,C(-)AT(+) 组和 C(+) 组的降钙素原和 C 反应蛋白水平显著升高( < .001)。C(-)AT(-) 组的 C 反应蛋白水平明显高于对照组( < .001)。与 C(-)AT(+) 组相比,C(+) 组的降钙素原水平无差异,与 C(-)AT(-) 组相比,对照组的降钙素原水平无差异。presepsin 未被发现可作为 COVID-19 患者败血症预测的有用生物标志物。这些研究结果表明,降钙素原和 C 反应蛋白可能是 COVID-19 重症患者继发感染的早期诊断标志物。

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