血清presepsin（sCD14-ST）联合NEWS评分评估脓毒症患者预后的价值  

The value of presepsin （sCD-14） combined with NEWS for predicting the prognosis of patients with sepsis

作　　者：全锦花[1] 杨鲁[2] 张新超[1] 

机构地区：[1]北京医院国家老年医学中心急诊科,北京100730 [2]北京大学第五医院北京医院急诊科

出　　处：《中华急诊医学杂志》2017年第8期948-952,共5页Chinese Journal of Emergency Medicine

摘　　要：目的探讨血清可溶性白细胞分化抗原14亚型（ sCD14-ST， presepsin）联合国家早期预警评分（national early warning score，NEWS）对急诊脓毒症预后评估中的价值。方法选择北京医院急诊科2012年9月至2015年7月就诊的脓毒症病人119例作为研究对象，来诊即刻收集血清标本测定presepsin、并进行NEWS评分。根据30天预后分为生存组81例和死亡组38例（31.9%），比较presepsin、NEWS评分和presepsin＋NEWS评分在脓毒症近期预后评估中的价值。结果（1）死亡组病例血清presepsin和NEWS评分均高于生存组（分别为1359.0（943.8，2582.8）和515.0（290.0，874.0），P〈0.05；9.5（7.0，13.0）和6.0（4.0，7.50），P〈005）；presepsin和NEWS都是脓毒症30天死亡的独立危险因素；（2）presepsin和NEWS的 ROC曲线下面积（AUC）分别为0.842、0.823，两者联测值的AUC为0.906；（3）以presepsin〉927.5pg/ml，NEWS〉6.5分为界值（cut off）评估不良预后有较好的效能。结论血清presepsin是评估脓毒症预后的较好指标，与NEWS联合能够提高对脓毒症死亡风险的预测能力。Objective To investigate the value of serum soluble leukocyte differentiation antigen 14 subtype （sCD14-ST, presepsin） combined with national early warning score （NEWS） for predicting the prognosis of emergency patients with sepsis. Methods To select 119 patients who came to the emergency department of Beijing Hospital with sepsis from September 2009 to July 2015 as the objects of the study. The serum samples were collected immediately as they came, the presepsin was measured, and the NEWS scorescalculated. Patients were divided into survival group （81 cases） and death group （38 cases） according to the 30-day prognosis, and the value of the presepsin, NEWS score and presepsin ＋ NEWS score in the assessment of prognosis were compared. Results Presepsin and NEWS scores both were higher in the death group than the survival group. Presepsin and NEWS were the independent risk factors of the 30- day mortality of patients with sepsis. Under the ROC curve area （AUC） of presepsin and NEWS were 0. 842 and 0. 823 ; the combination of Presepsin and NEWS was 0. 906. When presepsin 〉 927.5 pg / mL and NEWS 〉 6. 5 points, it can significantly improve the efficacy of predicting prognosis. Conclusions Serum presepsin is a good indicator to judge the prognosis of patients with sepsis, and the combination with NEWS can improve the ability to predict the risk of septic death.

关 键 词：脓毒症 可溶性白细胞分化抗原14亚型 NEWS评分 预后 

分 类 号：R459.7[医药卫生—急诊医学]