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单核细胞分布宽度,一种用于早期脓毒症筛查的新型生物标志物及其与降钙素原和C反应蛋白的比较

Monocyte Distribution Width, a Novel Biomarker for Early Sepsis Screening and Comparison with Procalcitonin and C-Reactive Protein.

作者信息

Meraj Fatima, Shaikh Sumera, Maqsood Sidra, Kanani Fatima, Khan Hamza, Jamal Saba

机构信息

Department of Hematology & Blood Center, Indus Hospital & Health Network, Karachi, Pakistan.

Indus Hospital Research Centre, Indus Hospital & Health Network, Karachi, Pakistan.

出版信息

J Lab Physicians. 2023 Jan 18;15(2):294-299. doi: 10.1055/s-0042-1758666. eCollection 2023 Jun.

DOI:10.1055/s-0042-1758666
PMID:37323592
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10264128/
Abstract

Monocyte distribution width (MDW) can be used for the early recognition of sepsis. The study compared the diagnostic accuracy of the MDW with two well-known sepsis biomarkers, procalcitonin (PCT) and C-reactive protein (CRP).  A study was conducted from July 2021 to October 2021, on 111 patients admitted to the Indus Hospital and Health Network. Patients from the ages of 1 to 90 years were enrolled if hospitalized for more than 24 hours for suspected sepsis to avoid inclusion of patients who had short-term stay in the emergency department. According to the Sequential Organ Failure Assessment score, the clinical team did the characterization of cases as with sepsis or without sepsis. SPSS version 24 was used, and the diagnostic accuracy of MDW was assessed and compared using the area under the curves (AUCs) acquired from receiver operating characteristic curves. Pearson's chi-square/Fisher's exact test (as per need) was applied to determine the association. A -value of less than 0.05 was considered significant.  Among 111 patients, 81 (73%) patients were labeled with sepsis and 30 (27%) were without sepsis. We have reported significantly higher MDW, PCT, and CRP levels in septic patients (  < 0.001). The AUC of MDW was comparable with PCT (0.794). Significant cutoff value for the MDW was greater than 20.24 U with 86% sensitivity and 73% specificity.  MDW may have a predictive ability similar to PCT and CRP in terms of sepsis and, thus, can be used as a standard parameter for the timely diagnosis of sepsis.

摘要

单核细胞分布宽度(MDW)可用于脓毒症的早期识别。该研究比较了MDW与两种著名的脓毒症生物标志物——降钙素原(PCT)和C反应蛋白(CRP)的诊断准确性。

2021年7月至2021年10月,对因都斯医院及健康网络收治的111例患者进行了一项研究。年龄在1至90岁之间、因疑似脓毒症住院超过24小时的患者被纳入研究,以避免纳入在急诊科短期停留的患者。根据序贯器官衰竭评估评分,临床团队对病例进行脓毒症或非脓毒症的特征描述。使用SPSS 24版本,通过从受试者工作特征曲线获得的曲线下面积(AUC)评估并比较MDW的诊断准确性。应用Pearson卡方检验/费舍尔精确检验(根据需要)来确定关联性。P值小于0.05被认为具有显著性。

在111例患者中,81例(73%)被诊断为脓毒症,30例(27%)无脓毒症。我们报告脓毒症患者的MDW、PCT和CRP水平显著更高(P < 0.001)。MDW的AUC与PCT相当(0.794)。MDW的显著临界值大于20.24 U,敏感性为86%,特异性为73%。

在脓毒症方面,MDW可能具有与PCT和CRP相似的预测能力,因此可作为脓毒症及时诊断的标准参数。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90c1/10264128/2f4b716ca2c2/10-1055-s-0042-1758666-i2261272-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90c1/10264128/d1dec1266dbf/10-1055-s-0042-1758666-i2261272-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90c1/10264128/2f4b716ca2c2/10-1055-s-0042-1758666-i2261272-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90c1/10264128/d1dec1266dbf/10-1055-s-0042-1758666-i2261272-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90c1/10264128/2f4b716ca2c2/10-1055-s-0042-1758666-i2261272-2.jpg

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