可溶性白细胞分化抗原14亚型联合qSOFA评分对脓毒症的早期诊断价值  

The Value of Soluble Leukocyte Differentiation Antigen 14 Subtype Combined with qSOFA Score in the Early Diagnosis of Sepsis

作　　者：郝绍文[1] 虎林 肖红科 周生虎[1] 杨立山[1] 陈中伟[1] 康向飞[1] HAO Shao-wen;HU Lin;XIAO Hong-ke;ZHOU Sheng-hu;YANG Li-shan;CHEN Zhong-wei;KANG Xiang-fei(Emergency Department,General Hospital of Ningxia Medical University,Yinchuan 750000,Ningxia,China)

机构地区：[1]宁夏医科大学总医院急诊科,宁夏银川750000

出　　处：《医学信息》2021年第18期170-172,共3页Journal of Medical Information

基　　金：宁夏医科大学校级课题(编号:XM2019048,XM2019057);睿E(睿意)急诊医学科研专项基金项目(编号:R2019025)。

摘　　要：目的探讨可溶性白细胞分化抗原14亚型(Presepsin)联合qSOFA评分在脓毒症患者早期诊断中的临床意义。方法选取2019年7月-2020年8月我科救治的121例系统性炎症反应综合征(SIRS)患者,根据脓毒症的诊断标准分为脓毒症组84例和非感染性SIRS组37例,比较两组Presepsin、C-反应蛋白(CRP)、降钙素原(PCT)表达情况及qSOFA评分;绘制ROC曲线,比较Presepsin联合qSOFA评分对脓毒症的早期诊断价值。结果脓毒症组Presepsin、CRP、PCT和qSOFA评分高于非感染性SIRS组,差异有统计学意义(P<0.05);ROC曲线显示,Presepsin预测脓毒症的ROC曲线下面积(AUC)为0.977(95%CI:0.956~0.998),敏感度为94.02%,特异度为89.19%;qSOFA评分预测脓毒症的ROC曲线AUC为0.859(95%CI:0.782~0.936),敏感度为90.50%,特异度为72.97%;Presepsin联合qSOFA评分检测预测脓毒症的ROC曲线AUC为0.988(95%CI:0.974~0.999),敏感度为90.50%,特异度为99.21%。结论Presepsin联合qSOFA评分可用于脓毒症的早期诊断,两者联合应用具有良好的预测价值。Objective To investigate the clinical significance of soluble leukocyte differentiation antigen 14 subtype(Presepsin)combined with qSOFA score in the early diagnosis of sepsis.Methods A total of 121 patients with systemic inflammatory response syndrome(SIRS)treated in our department from July 2019 to August 2020 were selected.According to the diagnostic criteria of sepsis,they were divided into 84 cases in sepsis group and 37 cases in non-infectious SIRS group.The expressions of Presepsin,C-reactive protein(CRP),procalcitonin(PCT)and qSOFA score were compared between the two groups;Drawing ROC curve and compare the value of Presepsin combined with qSOFA score in the early diagnosis of sepsis.Results The scores of Presepsin,CRP,PCT and qSOFA in the sepsis group were higher than those in the non-infectious SIRS group,the difference was statistically significant(P<0.05);The ROC curve showed that the area under the ROC curve(AUC)of Presepsin predicting sepsis was 0.977(95%CI:0.956-0.998),the sensitivity was 94.02%,and the specificity was 89.19%;The ROC curve AUC of qSOFA score predicting sepsis was 0.859(95%CI:0.782-0.936),the sensitivity was 90.50%,and the specificity was 72.97%;Presepsin combined with qSOFA score detection predicts sepsis ROC curve AUC was 0.988(95%CI:0.974-0.999),sensitivity was 90.50%,specificity was 99.21%.Conclusion Presepsin combined with qSOFA score can be used for the early diagnosis of sepsis,and the combination of the two has good predictive value.

关 键 词：可溶性白细胞分化抗原14亚型 qSOFA评分 脓毒症 降钙素原 C-反应蛋白 

分 类 号：R459.7[医药卫生—急诊医学]