Presepsin在急性盆腔炎诊断及疗效评估中的临床价值

Clinical value of presepsin in the diagnosis and curative effect evaluation of acute pelvic inflammatory

目的研究presepsin对急性盆腔炎的诊断和疗效评估价值。方法检测2014年6月-2016年5月来医院就诊的116例急性盆腔炎患者和60例健康体检者的presepsin、降钙素原水平。采用ROC曲线法评价presepsin对急性盆腔炎的诊断价值,并与PCT进行比较。根据疗效分为痊愈组、有效组、无效组,并对各组患者治疗前后的血浆presepsin、降钙素原水平进行比较。结果急性盆腔炎患者组presepsin、PCT浓度均高于对照组,差异有统计学意义(P<0.01)。presepsin的诊断界值为317 pg/ml,敏感度和特异度分别为69.2%和83.6%;PCT的诊断界值为0.25 ng/ml,敏感度和特异度分别为55.8%和75.5%,presepsin诊断急性盆腔炎的敏感度和特异度均高于PCT。痊愈组、有效组治疗后presepsin、PCT水平低于治疗前,差异均有统计学意义(P<0.05);无效组治疗后presepsin、PCT水平与治疗前比较,差异均无统计学意义(P>0.05)。结论 presepsin可作为急性盆腔炎的诊断生物标志物,其诊断价值与PCT相当,对急性盆腔炎的疗效评估具有潜在的临床价值。

Objective To investigate the diagnostic and curative effect evaluation of presepsin for acute pelvic inflammatory.Methods The plasma presepsin and serum PCT levels of 116 acute pelvic inflammatory patients and 60 healthy individuals admitted to hospital from June 2014 to Mar 2016 were detected. Receiver operating characteristic（ ROC） curve analysis was used to assess and compare the diagnostic value of presepsin with PCT. According to the treatment effect,patients were classified into the cure group,effective group and invalid group. The differences of presepsin and PCT levels were compared before and after treatment in each group. Results Acute pelvic inflammatory patients had higher presepsin and PCT levels than thealthy individual controls,with the differences statistically significant（ P 〈 0. 01）. The diagnostic cut- off of presepsin was 317 pg/ml,with sensitivity and specificity of 69. 2% and 83. 6% respectively. The diagnostic cut- off of PCT was 0. 25 ng/ml,with sensitivity and specificity of 55. 8%,75. 5% respectively. Therefore,presepsin displayed a higher sensitivity and specificity than PCT. Presepsin and PCT levels of cure group and effective group after treatment were significantly lower than that before treatment,with the differences statistically significant（ P 〈 0. 05）. Presepsin and PCT levels of invalid group after treatment,compared with that before treatment,had no statistical significance on the differences（ P 〉 0. 05）. Conclusion Presepsin could be used as a diagnostic biomarker for acute pelvic inflammatory. The diagnostic value of presepin was identical with PCT. Presepsin had potential clinical value in curative effect evaluation for acute pelvic inflammatory.