Presepsin、PCT和CRP对老年人脓毒症的早期诊断价值

The Value of Presepsin, PCT and CRP in the Early Diagnosis of Sepsis in the Elderly

目的探讨血清Presepsin、降钙素原(PCT)和C-反应蛋白(CRP)对老年人脓毒症的早期诊断价值。方法对86例脓毒症患者(分为较轻脓毒症患者48例和严重脓毒症患者38例)、30例非感染全身炎症反应综合征(SIRS)患者、50例肺部细菌感染非SIRS患者及50例健康人血清Presepsin、PCT和CRP进行定量测定。结果 Presepsin、PCT和CRP诊断老年人脓毒症的ROC曲线下面积(AUC)分别为0.86、0.82和0.73。Presepsin诊断老年人脓毒症的灵敏度(SEN)和特异性(SPE)分别为84.9%和83.8%。PCT诊断老年人脓毒症的SEN和SPE分别为75.6%和86.9%。CRP诊断老年人脓毒症的SEN和SPE分别为82.6%和70.8%。Presepsin、PCT和CRP并联试验诊断脓毒症的灵敏度和特异度分别为90.7%和63.8%。Presepsin、PCT和CRP串联试验诊断脓毒症的灵敏度和特异度分别为69.8%和90.8%。结论血清Presepsin、PCT和CRP对老年人脓毒症都有中等诊断价值,但Presepsin的诊断准确度优于PCT和CRP。

Objective To investigate the value of serum Presepsin, procalcitonin （PCT） and C- reactive protein （CRP） in the early diagnosis of sepsis in the elderly. Methods The serum levels of Presepsin, PCT and CRP were determined in 86 patients with sepsis（divided into mild sepsis in 48 patients and severe sepsis in 38 patients）, 30 patients with non infectious systemic inflammatory response syndrome （SIRS）, 50 patients with pulmonary bacterial infection and non SIRS patients, and 50 healthy controls. Results The area under the ROC curve （AUC） of Presepsin, PCT and CRP in the diagnosis of sepsis in the elderly was 0.86, 0.82 and 0.73, respectively. The sensitivity （SEN） and specificity （SPE） of Presepsin in the diagnosis of sepsis in the elderly were 84.9% and 83.8%, respectively. The SEN and SPE of PCT in the diagnosis of sepsis in the elderly were 75.6% and 86.9%, respectively. The SEN and SPE of CRP in the diagnosis of sepsis in the elderly were 82.6% and 70.8%, respectively. The sensitivity and specificity of Presepsin, PCT and CRP parallel tests in diagnosis of sepsis were 90.7% and 63.8%, respectively. The sensitivity and specificity of Presepsin, PCT and CRP in the diagnosis of sepsis were 69.8% and 90.8%, respectively. Conclusion Serum presepsin, PCT and CRP have moderate diagnostic value for sepsis in the elderly, but the diagnostic accuracy of Presepsin is better than that of PCT and CRP.