可溶性CD14亚型在脓毒症患者诊断和预后评估中的应用  

Application of soluble CD14 subtypes in the diagnosis and prognosis of patients with sepsis

作　　者：刘凌云[1] 赵元明[1] 申爱华[1] 陆书华[1] 李晓哲[1] 山凤莲[1] LIU Lingyun;ZHAO Yuanming;SHEN A ihua;LU Shuhua;LI Xiaozhe;SHAN Fenglian(Clinical Laboratory,the Affiliated Hospital of Jining Medical University,Jining 272029,Chin)

机构地区：[1]济宁医学院附属医院检验科,山东济宁272029

出　　处：《中国现代医生》2018年第18期107-110,共4页China Modern Doctor

基　　金：山东省济宁市科技发展计划项目(济科字[2016]56号-36)

摘　　要：目的探讨可溶性CD14亚型(sCD14-ST,presepsin)在脓毒症患者诊断和预后评估中的应用。方法选择2016年5月~2017年8月来我院就诊的80例脓毒症患者和80例非感染性全身炎症反应综合征患者为研究对象,脓毒症患者为观察组,非感染性全身炎症反应综合征患者为对照组,比较两组患者观察两组患者sCD14-ST、C-反应蛋白(C-reactive protein,CRP)、降钙素原(procalcitonin,PCT)的表达情况,同时应用ROC(receiver operating characteristic curve)曲线分析sCD14-ST、CRP、PCT及联合检测在脓毒症患者诊断和预后评估中参考意义。结果观察组患者sCD14-ST、PCT水平均高于对照组患者,差异有统计学意义(P<0.05);观察组患者CRP水平和对照组无显著差异(P>0.05);ROC曲线结果显示:sCD14-ST的ROC曲线下面积为0.972,界值为837.6,敏感性为96%,特异性为91%,CRP的ROC曲线下面积为0.479,界值为37.2,敏感性为51%,特异性为52%,PCT的ROC曲线下面积为0.918,界值为0.5,敏感性为90%,特异性为72%,sCD14-ST、CRP、PCT三者联合的曲线下面积为0.989,敏感性为97%,特异性为98%。结论 sCD14-ST对脓毒症患者诊断和预后评估有重要的临床价值,且sCD14-ST、CRP、PCT三者联合对脓毒症患者的诊断和预后评估的临床价值更高,值得临床推广应用。Objective To investigate the application of soluble CD14 subtype （sCD14-ST, presepsin）in the diagnosis and prognosis evaluation of patients with sepsis. Methods 80 patients with sepsis and 80 patients with non-infective systemic inflammatory response syndrome who were admitted to our hospital from May 2016 to August 2017 were selected as the study subjects. The patients with sepsis was assigned to the observation group. Patients with non-infectious systemic inflammatory response syndrome were assigned to the control group. The expression of sCD14-ST, C-reactive protein（CRP）, and procalcitonin（PCT） were observed and compared between the two groups. At the same time, receiver operating characteristic curve （ROC） was applied to analyze the significance of reference for sCDI4-ST, CRP, PCT and combined determinations in the diagnosis and prognosis evaluation for patients with sepsis. Results The sCD14-ST and PCT levels in the observation group were higher than those in the control group. The difference was sta- tistically significant（P〈0.05）. There was no significant difference in CRP level between the observation group and the control group（P〉0.05）; ROC curve results showed that the area under the ROC curve of sCD14-ST was 0.972, and the cutoff value was 837.6. The sensitivity was 96% and the specificity was 91%. The area under the ROC curve of CRP was 0.479, the cut-off value was 37.2, the sensitivity was 51%, and the specificity was 52%. The area under the ROC curve of the PCT was 0.918, the cut-off value was 0.5, the sensitivity was 90%, and the specificity was 72%. The area under the curve of sCD14-ST, CRP and PCT combined was 0.989, with a sensitivity of 97% and a specificity of 98%. Conclusion sCD14-ST has an important clinical value in the diagnosis and prognosis evaluation of patients with sepsis. The combination of sCD14-ST, CRP and PCT has a higher clinical value for the diagnosis and prognosis evaluation of patients with sepsis and is worthy of clinical promotion and application

关 键 词：可溶性CD14亚型 脓毒症 诊断 预后评估 

分 类 号：R459.7[医药卫生—急诊医学]