C 反应蛋白、降钙素原和白细胞介素-6 对血流感染患者 30 天死亡率的预测价值。
Predictive value of C-reactive protein, procalcitonin, and interleukin-6 on 30-day mortality in patients with bloodstream infections.
机构信息
Clinical Laboratory Center, Hospital of Traditional Chinese Medicine Affiliated to Xinjiang Medical University, Urumqi, Xinjiang 830099, PR China; State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Laboratory Center, Tumor Hospital Affiliated to Xinjiang Medical University, Urumqi 830000, PR China.
State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Laboratory Center, Tumor Hospital Affiliated to Xinjiang Medical University, Urumqi 830000, PR China.
出版信息
Med Clin (Barc). 2023 Jun 23;160(12):540-546. doi: 10.1016/j.medcli.2023.01.022. Epub 2023 Mar 24.
BACKGROUND
We aimed to assess the predictive performance of C-reactive protein (hsCRP), procalcitonin (PCT), and interleukin-6 (IL-6) at different times points of bloodstream infections (BSI) management.
METHODS
The cases were collected from January 2020 to June 2021 in the First Affiliated Hospital of Xinjiang Medical University (n=185). We collected patients' records of hsCRP, PCT, and IL-6 serum levels and calculated the clearance of these biomarkers on day 1, day 3, and day 5 (hsCRP-1, hsCRP-3, hsCRP-5, so do PCT, and IL-6). We analyzed these predictive performances for 30-day mortality with ROC and Logistic regression. The correlation between biomarkers and their clearance rates was performed by a rank correlation method.
RESULTS
The 30-day mortality was 11.35% (21/185). Serial serum hsCRP-3, IL-6-3, PCT-1, PCT-3, and PCT-5 were statistically higher in BSI mortality than survivors. Significant predictive ability was found for 30-day mortality with blood culture (BC) reported fungi (OR, 0.033; 95% CI: 0.002-0.535) and PCT-5 (OR, 1.045; 95% CI: 1.013-1.078) levels, respectively. The AUC of PCT-5 levels for 30-day mortality was 0.784 (95% CI 0.678-0.949), and the cut-off value was 5.455ng/mL.
CONCLUSIONS
PCT-5 is more valuable for the prognosis of 30-day mortality in patients with BSI compared to the other inflammatory biomarkers.
背景
我们旨在评估 C 反应蛋白（hsCRP）、降钙素原（PCT）和白细胞介素 6（IL-6）在血流感染（BSI）管理不同时间点的预测性能。
方法
本病例收集于 2020 年 1 月至 2021 年 6 月新疆医科大学第一附属医院（n=185）。我们收集了患者 hsCRP、PCT 和 IL-6 血清水平的记录，并计算了这些生物标志物在第 1 天、第 3 天和第 5 天的清除率（hsCRP-1、hsCRP-3、hsCRP-5，PCT 和 IL-6 也是如此）。我们使用 ROC 和 Logistic 回归分析了这些生物标志物对 30 天死亡率的预测性能。使用秩相关方法分析了生物标志物与其清除率之间的相关性。
结果
30 天死亡率为 11.35%（21/185）。BSI 死亡患者的血清 hsCRP-3、IL-6-3、PCT-1、PCT-3 和 PCT-5 的水平均显著高于存活者。血培养（BC）报告真菌（OR，0.033；95%CI：0.002-0.535）和 PCT-5（OR，1.045；95%CI：1.013-1.078）水平对 30 天死亡率具有显著预测能力。PCT-5 水平对 30 天死亡率的 AUC 为 0.784（95%CI 0.678-0.949），截断值为 5.455ng/mL。
结论
与其他炎症生物标志物相比，PCT-5 对 BSI 患者 30 天死亡率的预后更有价值。
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