Department of Emergency, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, P.R. China.
Clin Chem Lab Med. 2022 Feb 28;60(6):952-958. doi: 10.1515/cclm-2022-0068. Print 2022 May 25.
The diagnosis of sepsis is challenging, the need for sensitive and specific diagnostic and prognostic biomarkers has not been met. Soluble CD25 (sCD25) is a readily available biomarker reported to represent the severity of the disease. This study aimed to assess the association between sCD25 and mortality in patients with sepsis.
In total, 329 adult patients with sepsis were screened through a prospective, observational study. We investigated the severity scores and sCD25 levels at admission to the intensive care unit (ICU), defined by sepsis (sepsis-3). The prognostic value of sCD25 was assessed using receiver operating characteristic (ROC) curves and binary logistic regression models in predicting unfavourable outcome. The correlations between variables and severity of disease were analysed by Spearman correlation tests.
After entering the ICU, the sCD25 level and sequential organ failure assessment (SOFA) score were significantly higher in nonsurvivors than in survivors. The prognostic values estimated by the ROC curves were 0.678 for sCD25 and 0.945 for SOFA score at ICU admission. sCD25 had a modest ability to predict poor outcome. Logistic regression showed that increased levels of sCD25 were independently associated with unfavourable outcome. Spearman correlation tests showed that sCD25 levels were positively correlated with disease severity.
In sepsis patients, increased sCD25 levels were independently associated with poor clinical outcomes. Further research is needed to improve the understanding of the pathophysiology of this relationship.
脓毒症的诊断具有挑战性，因此需要灵敏且特异的诊断和预后生物标志物，但目前尚未满足这一需求。可溶性 CD25（sCD25）是一种易于获得的生物标志物，据报道其可代表疾病的严重程度。本研究旨在评估脓毒症患者 sCD25 与死亡率之间的相关性。
通过前瞻性观察性研究共筛选了 329 例成年脓毒症患者。我们研究了他们入住重症监护病房（ICU）时的严重程度评分和 sCD25 水平，这些患者的脓毒症是根据脓毒症 3 标准定义的。通过受试者工作特征（ROC）曲线和二元逻辑回归模型评估 sCD25 预测不良结局的预后价值。采用 Spearman 相关检验分析变量与疾病严重程度之间的相关性。
入住 ICU 后，非幸存者的 sCD25 水平和序贯器官衰竭评估（SOFA）评分明显高于幸存者。ROC 曲线估计的预后价值为：sCD25 在 ICU 入院时为 0.678，SOFA 评分为 0.945。sCD25 预测不良结局的能力中等。逻辑回归显示，sCD25 水平升高与不良结局独立相关。Spearman 相关检验显示，sCD25 水平与疾病严重程度呈正相关。
在脓毒症患者中，sCD25 水平升高与不良临床结局独立相关。需要进一步研究以加深对这种关系病理生理学的理解。
