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1.
AIM To evaluate the diagnostic and prognostic value of presepsin in cirrhosis-associated bacterial infections. METHODS Two hundred and sixteen patients with cirrhosis were enrolled. At admission, the presence of bacterial infections and level of plasma presepsin, serum C-reactive protein(CRP) and procalcitonin(PCT) were evaluated. Patients were followed for three months to assess the possible association between presepsin level and short-term mortality.RESULTS Present 34.7 of patients had bacterial infection. Presepsin levels were significantly higher in patients with infection than without(median, 1002 pg/m L vs 477 pg/m L, P 0.001), increasing with the severity of infection [organ failure(OF): Yes vs No, 2358 pg/m L vs 710 pg/m L, P 0.001]. Diagnostic accuracy of presepsin for severe infections was similar to PCT and superior to CRP(AUC-ROC: 0.85, 0.85 and 0.66, respectively, P = NS for presepsin vs PCT and P 0.01 for presepsin vs CRP). At the optimal cut-off value of presepsin 1206 pg/m L sensitivity, specificity, positive predictive values and negative predictive values were as follows: 87.5%, 74.5%, 61.8% and 92.7%. The accuracy of presepsin, however, decreased in advanced stage of the disease or in the presence of renal failure, most probably because of the significantly elevated presepsin levels in non-infected patients. 28-d mortality rate was higher among patients with 1277 pg/m L compared to those with ≤ 1277 pg/m L(46.9% vs 11.6%, P 0.001). In a binary logistic regression analysis, however, only PCT(OR = 1.81, 95%CI: 1.09-3.01, P = 0.022) but neither presepsin nor CRP were independent risk factor for 28-d mortality after adjusting with MELD score and leukocyte count.CONCLUSION Presepsin is a valuable new biomarker for defining severe infections in cirrhosis, proving same efficacy as PCT. However, it is not a useful marker of short-term mortality.  相似文献   
2.
The clinical usefulness of presepsin for discriminating between bacterial and nonbacterial infections (including systemic inflammatory response syndrome) was studied and compared with procalcitonin (PCT) and interleukin-6 (IL-6) in a multicenter prospective study. Suspected sepsis patients (n = 207) were enrolled into the study. Presepsin levels in patients with systemic bacterial infection and localized bacterial infection were significantly higher than in those with nonbacterial infections. In addition, presepsin, PCT, and IL-6 levels in patients with bacterial infectious disease were significantly higher than in those with nonbacterial infectious disease (P < 0.0001, P < 0.0001, and P < 0.0001, respectively). The area under the receiver operating characteristic curve was 0.908 for presepsin, 0.905 for PCT, and 0.825 for IL-6 in patients with bacterial infectious disease and those with nonbacterial infectious disease. The cutoff value of presepsin for discrimination of bacterial and nonbacterial infectious diseases was determined to be 600 pg/ml, of which the clinical sensitivity and specificity were 87.8 % and 81.4 %, respectively. Presepsin levels did not differ significantly between patients with gram-positive and gram-negative bacterial infections. The sensitivity of blood culture was 35.4 %; that for presepsin was 91.9 %. Also there were no significant differences in presepsin levels between the blood culture-positive and -negative groups. Consequently, presepsin is useful for the diagnosis of sepsis, and it is superior to conventional markers and blood culture.  相似文献   
3.

Purpose

Presepsin has recently emerged as a new useful sepsis marker, and our study is focused on the usefulness of presepsin as earlier detection and monitoring biomarker for sepsis comparing with other conventional biomarkers.

Materials and methods

We compared the mean values of presepsin, procalcitonin, interleukin 6, and high-sensitivity C-reactive protein levels between infection group and noninfection group of study subjects and assessed whether the values decreased during treatment. Furthemore, we evaluated the diagnostic accuracy of presepsin in sepsis and compared the mean level of presepsin to the Acute Physiology and Chronic Health Evaluation III score and mortality rate on the 30th day.

Results

Mean presepsin levels were significantly different between infection group and noninfection group (1403.47 pg/mL vs 239.00 pg/mL). During treatment, mean levels of presepsin decreased significantly, and in the receiver operating characteristic curve analysis, the area under curve value of presepsin was significantly higher than that of other biomarkers. The presepsin levels did not correlate significantly with Acute Physiology and Chronic Health Evaluation III scores and mortality rates on the 30th day.

Conclusions

Presepsin showed significantly higher values in infection group than in noninfection group. The diagnostic accuracy of presepsin was higher than other conventional biomarkers. For early diagnosis and treatment of bacterial sepsis, presepsin could be a more useful marker than the other markers.  相似文献   
4.
CD14 is present in macrophage, monocyte, and granulocyte cells and their cell membranes, and it is said to be responsible for intracellular transduction of endotoxin signals. Its soluble fraction is present in blood and is thought to be produced in association with infections. It is called the soluble CD14-subtype (sCD14-ST), and in the following text it is referred to by its generic name, presepsin. We have previously reported that presepsin is produced in association with infection and that it is specifically expressed in sepsis. In the present study we developed a new rapid diagnostic method by using a chemiluminescent enzyme immunoassay that allowed making automated measurements in a shorter time. The results of using this method to measure presepsin values in different pathological conditions were normal, 294.2 ± 121.4 pg/ml; local infection, 721.0 ± 611.3 pg/ml; systemic inflammatory response syndrome, 333.5 ± 130.6 pg/ml; sepsis, 817.9 ± 572.7 pg/ml; and severe sepsis, 1,992.9 ± 1509.2 pg/ml; the presepsin values were significantly higher in patients with local infection, sepsis, and severe sepsis than in patients who did not have infection as a complication. In a comparative study with other diagnostic markers of sepsis based on ROC curves, the area under the curve (AUC) of presepsin was 0.845, and greater than the AUC of procalcitonin (PCT, 0.652), C-reactive protein (CRP, 0.815), or interleukin 6 (IL-6, 0.672). In addition, a significant correlation was found between the APACHE II scores, an index of disease severity, and the presepsin values, suggesting that presepsin values can serve as a parameter that closely reflects the pathology.  相似文献   
5.
目的荟萃分析血清可溶性白细胞分化抗原14亚型(sCD14-ST,presepsin)检测对新生儿败血症(NS)的诊断价值。 方法采用Cochrane系统评价方法,应用计算机检索PubMed、Web of Science等英文数据库,以及中国知网、万方数据知识服务平台等中文数据库中,有关血清presepsin检测对NS诊断价值的前瞻性或回顾性病例对照研究文献。检索时间设定为1990年1月至2020年9月。按照本研究设定的检索策略进行文献检索、筛选、提取,采用诊断准确性研究质量评价工具(QUADAS-2)进行文献质量评价,采用Meta-Disc 1.4及Stata 14.0软件进行Meta分析。血清presepsin检测诊断NS的主要结局指标为合并敏感度、特异度、阳性似然比(PLR)、阴性似然比(NLR)、诊断比值比(DOR),汇总受试者工作特征(SROC)曲线及其曲线下面积(AUC)。采用血清presepsin检测诊断NS的SROC曲线分布特征及其敏感度对数与(1-特异度)对数的Spearman相关系数,评价阈值效应;采用Cochrane-Q检验分析纳入研究文献的异质性,并采用亚组分析进一步探讨该异质性来源。绘制Deek′s漏斗图,分析文献发表偏倚。 结果对最终纳入的15篇文献中血清presepsin检测诊断NS价值研究结果如下。①共计纳入6个国家的1 394例新生儿,研究组为NS患儿(n=812),对照组为非NS患儿(n=582)。②本研究纳入文献偏倚风险均在可接受范围,NS诊断标准适用性高,符合QUADAS-2质量评价标准。③绘制纳入15篇文献中,血清presepsin检测诊断NS的SROC曲线结果显示,SROC曲线未呈典型"肩臂状"分布,诊断NS敏感度对数与(1-特异度)对数的Spearman相关系数为-0.020(P=0.945),表明研究间不存在阈值效应。血清presepsin检测诊断NS敏感度、特异度、PLR、NLR、DOR,均存在高度异质性(I2=81.0%、75.8%、67.2%、76.3%、68.7%,P均<0.001),提示纳入研究文献间存在非阈值效应引起的异质性,故采用随机效应模型进行Meta分析。血清presepsin检测诊断NS的合并敏感度为89%(95%CI:87%~91%,P<0.001),合并特异度为90%(95%CI:88%~93%,P<0.001),合并PLR为8.39(95%CI:5.18~13.60,P<0.001),合并NLR为0.13(95%CI:0.09~0.21,P<0.001),合并DOR为98.83(95%CI:43.21~226.07,P<0.001),SROC-AUC为0.96(95%CI:0.95~0.98)。亚组分析结果显示,纳入研究文献异质性来源,可能为血清presepsin检测方法[酶联免疫吸附测定(ELISA):血清presepsin检测诊断NS的PLR为12.10(6.31~23.17),I2=42.9%、P=0.105,DOR为270.76(84.62~866.32),I2=40.5%、P=0.121;化学发光酶联免疫分析(CLEIA):血清presepsin检测诊断NS的PLR为5.80(3.27~10.28),I2=65.9%、P=0.005,DOR为45.47(17.5~118.15),I2=69.0%、P=0.002]。④Deek′s漏斗图显示,纳入15篇文献基本对称分布于回归线2侧,并且差异无统计学意义(P=0.640)。 结论本研究纳入15篇文献的血清presepsin检测对NS患儿具有较高诊断价值,使用ELISA法检测血清presepsin诊断NS的结果更为准确、可信。受纳入文献的研究对象和研究质量限制,上述结论尚待更多高质量研究予以证实。  相似文献   
6.
7.
IntroductionThis study aimed to identify factors affecting presepsin levels and to determine their diagnostic utility.MethodsThis cross-sectional study was conducted at an outpatient clinic and emergency department at an acute care hospital in Japan between January 2015 and December 2017. We enrolled 1,840 consecutive outpatients with at least one measurement of serum presepsin, who were suspected of having bacterial infection. The outcome variables were bacterial infection, lower respiratory tract infection, urinary tract infection, cholangitis, and other infections diagnoses, based on the chart review. We collected blood analysis data on the patients’ presepsin levels.ResultsThere was a significant association between presepsin level and the diagnosis of bacterial infection even when adjusted for age, sex, renal function, and biliary enzyme levels. An increase of 1 unit in the log of presepsin values resulted in a relative risk ratio of 1.71 (1.09–2.66), 2.1 (1.58–2.79), 2.93 (2.05–4.19), 4.7(2.90–7.61), and 2.41(1.70–3.43), for bacterial infection, lower respiratory tract infection, urinary tract infection, cholangitis, and other infections, respectively.ConclusionsPresepsin showed a statistically significant increase in the diagnosis of bacterial infections (lower respiratory tract infections, urinary tract infections, cholangitis, and non-severe patients) in a community hospital setting. However, in patients with renal dysfunction, presepsin levels should be interpreted with caution.  相似文献   
8.
9.
袁晶  张晓冬  康健 《当代医学》2021,27(7):92-95
目的探讨可溶性CD14分子亚型(Presepsin)在肝硬化自发性细菌性腹膜炎(SBP)患者诊断中的价值。方法选取2016年6月至2017年10月大连医科大学附属第一医院消化内科和感染科收治的符合肝硬化和SBP诊断标准的患者63例作为研究对象,根据疾病类型分为SBP组(n=21)、肝硬化腹水组(n=22)和单纯肝硬化组(n=20),后两组患者根据Child-Pugh评分进一步分为A级组(n=20)、B级组(n=13)和C级组(n=9),同时,选取健康志愿者作为对照组(n=48)。比较各组患者Presepsin水平,并绘制受试者工作特征曲线(ROC)。结果SBP组、肝硬化腹水组及单纯肝硬化组血Presepsin水平明显升高(P<0.05),且SBP组Presepsin高于肝硬化腹水组,肝硬化腹水组高于单纯肝硬化组(P<0.05);Presepsin对SBP诊断的ROC曲线下面积(AUC)为0.842,最佳截断点为520 pg/mL,敏感性及特异性分别为85.7%和77.3%。A级组、B级组和C级组Presepsin水平随Child-Pugh分级的增高而升高。结论Presepsin对于SBP有诊断价值,且可预测肝硬化患者肝脏损害的严重程度。  相似文献   
10.

Background

Diagnosing sepsis is difficult in burn patients because of the inflammatory mediators that alter postburn metabolic profile. Here, we compare a new marker presepsin with procalcitonin (PCT), c-reactive protein (CRP) and white blood cell (WBC) in diagnosis and follow up of sepsis in burn patients.

Methods

Patients admitted to burn center of our institute were prospectively investigated. Presepsin, PCT, CRP and WBC levels were measured at admission and every 6 h for first day and daily thereafter. At all timing samples, patients were classified as sepsis or non-sepsis according to the current American Burn Association Consensus Criteria (ABA) 2007.

Result

37 adult patients were evaluated. A total data of 611 time points were supplied. Sepsis time points differ significantly from non-sepsis in presepsin (p < 0.0001), PCT (p = 0.0012) and CRP (p < 0.0001) levels. Non-surviving patient results differ significantly from survivors in presepsin (p < 0.0001), PCT (p = 0.0210) and CRP (p = 0.0008). AUC-ROC % values for diagnosing sepsis were 83.4% for presepsin, 84.7% for PCT, 81.9% for CRP and 50.8% for WBC. Sepsis patients had significantly different presepsin, CRP and WBC but not PCT levels on their first day of sepsis compared to previous days.

Conclusion

Plasma presepsin levels have comparable performance in burn sepsis.  相似文献   
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