The Diagnostic Value And Prognostic Effect Of Presepsin In Sepsis

Objective To investigate the application value of sc D14-ST(Presepsin)in the diagnosis of sep sis.Methods A total of 88 patients with SIRS≥2 points were enrolled in the intensive care Unit(I CU),emergency intensive care Unit(EICU),respiratory and critical care medicine department of The Affiliated Hospital of Inner Mongolia Medical University from December 2020 to De cember 2021.Patients were divided into the sepsis group and the SIRS group according to the sepsis 3.0 definition.Patients with sepsis were divided into two subgroups,sepsis and septic s hock,according to the severity of their disease.Healthy volunteers were randomly included as the control group.Plasma samples were collected immediately after admission to test presepsi n,and blood samples were taken for procalcitonin(PCT),C-reactive protein(CRP)and blood routine tests.Body temperature,respiratory rate,heart rate,blood pressure,fever,urine volum e,white blood cell count(WBC),platelet count,serum creatinine,serum total bilirubin,menta l status and GCS score were recorded.All patients were sampled for blood culture several time s.The collected blood samples were placed in the refrigerator at-80 ℃,and presespin was det ected after collection.Thepresepsin differences of sepsis,SIRS and control group were compared.Area Under the ROC Curvea(AUC)was used to investigate the value of PREsepsin,PCT,CR P,SOFA score,WBC and their combination in the diagnosis of sepsis.Patients in the sepsis gr oup were followed up for 30 days,divided into survival group and death group.ROC curve w as also used to evaluate the prognostic value of presepsin for sepsis patients.Results1.He presepsin level of sepsis patients was 80.56 ± 35.68ng/ml,that of SIRS group was44.23 ± 21.05ng/ml,and that of control group was 16.45 ± 6.94ng/ml.The presepsin value in sepsis group was higher than that in SIRS group(P < 0.001),and the presepsin value in SIRS group was higher than that in control group(P < 0.001).The area under the ROC curve of presepsin was 0.82.When 55.84ng/ml was taken as the cut-off point,the sensitivity and specificity of presepsin in the diagnosis of sepsis were 72.22% and 79.41%;The area under the ROC curve of SOFA score was 0.73.When the cut-off point value was 5.50,the sensitivity and specificity of sepsis diagnosis were 70.37% and 67.65%;The area under the ROC curve of PCT was 0.73.When the cut-off point value was 12.46ng/ml,the sensitivity and specificity for the diagnosis of sepsis were 77.78% and 64.71%;Presepsin alone is better than CRP,WBC,PCT and sofa in the diagnosis of sepsis.The area under the curve of PCT,CRP,WBC and sofa combined with ROC was 0.81,the sensitivity was 77.78%,and the specificity was 76.47%;The area under ROC curve of presepsin combined with PCT,CRP,WBC and SOFA score is 0.89,the sensitivity is 85.19%,and the specificity is 76.47%,which can further improve the diagnostic efficiency of sepsis.Presepsin has certain value in the diagnosis of sepsis.2.The sepsis group was divided into sepsis group(21 cases)and septic shock group(33cases)according to the severity of the disease.There was no significant difference in age and gender between the two groups.The presepsin value in sepsis group was 62.79 ± 27.12ng/ml and that in septic shock group was 90.81 ± 36.52ng/ml.The presepsin value in septic shock group was higher than that in sepsis group(P < 0.05);The SOFA score of sepsis group was6.43 ± 3.84 and that of septic shock group was 9.15 ± 4.25.There was significant difference between the two groups.Spearman rank correlation analysis showed that presepsin index and SOFA score were correlated with the severity of sepsis(P < 0.05).3.According to the prognosis,the sepsis group was divided into death group and survival group.The presepsin value of death group was 110.47 ± 39.58ng/ml higher than that of survival group was 67.05 ± 24.79ng/ml.The difference between the two groups was statistically significant.When presepsin alone was used to predict the prognosis of patients with sepsis,the area under the ROC curve was 0.82.When 69.13ng/ml was taken as the cut-off value,the sensitivity was 93.75% and the specificity was 60.53%;The AUC value of SOFA score in predicting the prognosis of patients with sepsis was 0.76.When taking 6.5 as the cut-off value,the sensitivity was 87.50% and the specificity was 55.26%;When used alone,presepsin and sofa scores predicted the prognosis of sepsis,which were similar and better than WBC,CRP and PCT.The area under the curve of WBC,CRP,PCT and sofa combined ROC was 0.79,the sensitivity was 87.50%,and the specificity was 65.79%;The sensitivity of sofa and CRP combined with PCC was 88.89%,and the specificity of prognosis was significantly improved by 25.89%.That is,presepsin alone has a certain value in the prognosis evaluation of sepsis.The combination of presepsin with WBC,CRP,PCT and sofa scores can further improve the efficiency of predicting the prognosis of sepsis.Conclusion.1.Presepsin has certain value in the diagnosis of sepsis.Presepsin combined with PCT,WBC,CRP and sofa scores can further improve the efficiency of diagnosing sepsis.2.Presepsin has predictive value for the death of patients with sepsis.The combined detection of presepsin with PCT,WBC,CRP and sofa scores can further improve the value of predicting the prognosis of patients with sepsis.