摘要
目的 探索肾上腺髓质素前体在脓毒症的早期诊断作用.方法 入住ICU且符合脓毒症诊断标准的患者75例,分为脓毒症组(54例)和非脓毒症组(21例).患者入住ICU当天抽血检测血清pro?ADM和PCT浓度,通过建立受试者工作特征曲线分析诊断指标的敏感性、特异性并确立临界值.结果 与非脓毒症组相比,脓毒症组proADM、PCT、CRP、WBC均显著增高, proADM、PCT、CRP浓度的升高具有统计学意义.proADM的曲线下面积较PCT、CRP大.proADM的敏感度与PCT相差不大(84% vs 86%),明显优于CRP、WBC.proADM的特异度、阳性预测值、阴性预测值均是100%,优于PCT、CRP、WBC.结论 血浆pro?ADM水平在脓毒症患者早期明显升高,推测可以用于脓毒症的早期诊断.Pro?ADM作为脓毒症诊断的生物标志物,相比传统指标PCT、WBC和CRP,在诊断准确性较高,有利于脓毒症的早期发现,早期诊断.
Objective To investigate the value of pro?adrenomedullin(pro?ADM)in the early diagnosis of sepsis.Methods Seventy?five patients admitted to ICU,who fulfilled the diagnostic criteria for sepsis,were divided into the sepsis group(n=54)and the non?sepsis group(n=21).Blood samples were collected at the day of ICU admission,and the concentrations of serum pro?ADM and PCT were measured.The sensitivity and specificity of the diagnostic biomarkers were analyzed by using receiver operating characteristic curve,and the critical values were established.Results Compared with the non?sepsis group,the concentrations of proADM,PCT,CRP,and WBC significantly increased in the sepsis group,and there were statistical significance in the increasing concentrations of proADM,PCT,and CRP.The area under the curve of proADM was larger than that of PCT and CRP.The sensitivity of proADM was not significantly different from that of PCT(84%vs 86%),which was significantly better than that of CRP and WBC.The specificity,positive predictive value and negative predictive value of proADM were all 100%,respectively,which were better than those of PCT,CRP and WBC.Conclusion Plasma pro?ADM level is significantly elevated in the early stage of sepsis,which may be used in the early diagnosis of sepsis.As a biomarker for the diagnosis of sepsis,Pro?ADM shows higher diagnostic accuracy than the conventional biomarkers PCT,WBC and CRP.It favors the early detection and early diagnosis of sepsis.
作者
熊梦然
陈雷
王丽纯
刘恩贺
肖朝兴
寇秋野
Xiong Mengran;Chen Lei;Wang Lichun;Liu Enhe;Xiao Chaoxing;Kou Qiuye(Department of Critical Care Medicine,Sixth Affiliated Hospital of Sun Yat?sen University,Guangzhou,Guangdong 510655,China)
出处
《中华生物医学工程杂志》
CAS
2019年第2期229-232,共4页
Chinese Journal of Biomedical Engineering
作者简介
通信作者:寇秋野,Email:kouqiuye@126.com
