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Objective:To investigate the clinical diagnostic value of soluble leukocyte differentiation antigen 14 subtype (sCD14-ST, presepsin) in elderly patients with acute left heart failure (AHF) complicated with bacterial pneumonia.Methods:The data of 111 elderly patients with acute left heart failure complicated with bacterial pneumonia or acute left heart failure (the control group) who were admitted into emergency department from August 2017 to August 2018 were retrospectively analyzed. Chemilluminescence immunoassay was performed to detect presepsin in all patients. And meanwhile, fever or not, presepsin, procalcitonin (PCT), C-reaction protein (CRP) and other clinical data were compared between the two groups. Univariate and multivariate logistic regression analysis were adopted to screen the risk factor influencing the diagnosis. The receiver operating characteristic (ROC) curve was used to analyze the clinical value of presepsin on diagnosing acute left heart failure complicated with bacterial pneumonia in elderly patients.Results:Presepsin of the group complicated with bacterial pneumonia was significantly higher than that of the control group [(500.9±283.5) ng/L vs. (167.7±102.3) ng/L, t=-7.902, P=0.000]. The logistic regression analysis, showed that fever, presepsin and procalcitonin were independent risk factors for AHF combined with bacterial pneumonia diagnosis. The area under ROC curve (AUC) of presepsin, PCT and WBC was 0.887 (95% CI: 0.825-0.949, P<0.001), 0.794(95% CI: 0.704-0.885, P<0.001), and 0.566 (95% CI: 0.455-0.678, P=0.231), respectively. The optimal threshold value of presepsin was 227 ng/L, the sensitivity was 82.0%, specificity was 83.6%, the positive likelihood ratio was 5, the negative likelihood ratio was 0.22, the positive predictive value) was 80.4%, and the negative predictive value was 85%. Conclusions:Presepsin has an important diagnostic value for the identification of AHF combined with bacterial pneumonia in elderly patients.
RESUMO
Objective To investigate the clinical diagnostic value of plasma soluble leukocyte differentiation antigen 14 (presepsin) in patients with rheumatoid arthritis (RA) complicated with pulmonary bacterial infection.Methods A total of 133 patients with RA and 60 healthy controls were enrolled in this study.Fifty-eight RA patients were infected with lung bacterial infection and 75 patients were non-infected with RA.Among them,RA activity was performed in 43 patients and RA was stable in 32 patients.Chemilluminescence immunoassay was used to detect presepsin (P-SEP) in all subjects,and its correlation with inflammatory markers such as white blood cells,blood sedimentation rate and C-reactive protein was analyzed.Results The P-SEP of RA (561 ±142) pg/ml combined with pulmonary bacterial infection group was significantly higher than that of active RA group (378±100) pg/ml (t=8.12,P＜0.01),higher than that of stable RA group (197±68) pg/ml (t=8.51,P＜0.01) and healthy control group (113±9) pg/ml (t=13.75,P＜0.01).There was a positive correlation between P-SEP and leukocyte count in patients with RA complicated with pulmonary bacterial infection (r=0.627,P＜0.01).The degree of the disease activity was correlated with CRP (r=0.63,P＜O.O1),regardless of the P-SEP level (r=0.47,P=0.521).The optimal threshold value of P-SEP in diagnosing RA patients with bacterial infection was 458.9 pg/ml,with a sensitivity of 79.3％ and a specificity of 81.4％.Conclusion P-SEP has an important diagnostic value for the identification of bacterial infection in RA patients,which is not related to RA disease activity.