Öz
Giriş: Son yıllarda presepsin, sepsisin erken tanısında faydalı olabilecek bir biyobelirteç olarak tanımlanmaktadır. Sistemik enflamatuvar yanıt sendromu (SIRS) ve sepsisli hastalarda presepsinin tanısal ve prognostik değerini değerlendirmeyi amaçladık.
Gereç ve Yöntem: Bu prospektif olgu kontrol çalışmasına toplam 65 hasta (SIRS, sepsis veya septik şok tanısı alan 42 hasta ve 23 sağlıklı kontrol) dahil edildi.
Bulgular: Hastaneye yatışın ilk gününde hasta grubunda presepsin [687,5 pg/ml (115-10049 pg/ml)] median değeri kontrol grubundan daha yüksekti [71,5 pg/ml (44,1-170 pg/ml)] (p<0,001). Sepsis ve septik şok grubunda presepsin düzeyleri SIRS grubuna göre daha yüksekti (p1: 0,002, p2: 0,001). Yatışının ilk günü ve tedavinin ikinci gününde hastalık şiddeti ile presepsin arasında pozitif korelasyon vardı (sırasıyla r=0,448, 0,423; p<0,001, p<0,001). Yatışının ilk günü için SIRS, sepsis ve septik şok için presepsin eşik değer 124 pg/ml alındığında, duyarlılık %97,6 ve özgüllük %95,7 [eğrinin altında kalan alan (AUC): 0,996 (p<0,001)] idi. Yatışının ilk günü için presepsisin cut-off değeri 439 pg/ml iken, sepsisi SIRS olgularından ayırmada presepsinin duyarlılığı %100 ve özgüllüğü %57,1 olmuştur [AUC: 0,772 (p<0,001)]. Yatışının ilk gününde presepsin eşik değeri 864 pg/ml olarak alındığında septik şokun sepsis ve SIRS olgularından %100 duyarlılık ve %69,4 özgüllük [AUC: 0,856 (p<0,001)] ile ayırt edildiği görüldü.
Sonuç: Presepsin, hızlı tanı ve tedavinin hayat kurtarıcı olduğu bilinen SIRS, sepsis ve septik şok hastalarının erken tanısında yararlı bir biyobelirteç gibi görünmektedir.
Anahtar Kelimeler: Biomarker, CD14, presepsin, sCD14-ST, sepsis
Kaynakça
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