Value of serum soluble ST2 in predicting the prognosis of sepsis / 中华急诊医学杂志

ABSTRACT

Objective To study the predictive value of serum soluble ST2 (sST2) in patients with sepsis.Methods A total of 63 patientswith sepsis and 30 healthy subjects as a control group in the emergency Department,Beijing Hospital,National Center of Gerontology,were enrolled in the study.Serum sST2 concentrations were measured by ELISA method.Patients were divided into sepsis group (n=44) and septic shock group (n=19).According to 28-day mortality after the diagnosis of sepsis,patients were divided into death group (n=18) and survival group (n=45).Respiratory rate,oxygenation index,white blood cell count,procalcitonin (PCT),C reactive protein (CRP),serum creatinine (CRE),total bilirubin (TBIL) of patients and control subjects were measured.SPSS 23.0 software was used for the statistical analyses.The measurement data was analyzed by t test and the enumeration data was analyzed by Chi square test.The survival status was analyzed by Logistic binary regression analysis and ROC curve analysis.Results The serum sST2 level (1 382.12±384.07) pg/mL in sepsis group was significantly higher than that in control group (569.28±163.46) pg/mL (P＜0.05).in septic shock group,28-day mortality rate (63.16％) and serum sST2 level (1 675.49±457.59) pg/mL was higher than those in sepsis group (13.64％) (1255.44 ± 265.70) pg/ml (P＜0.05).The PCT (16.37±16.36) ng/mL and serum sST2 level (1794.47±335.18)pg/mL in death group were higher than those in survival group (P＜0.05).The ROC curve showed that the AUC of sST2 was larger than that of PCT (0.917 vs.0.884),the sensitivity was higher than that of PCT (88.9％ vs.72.2％),and the specificity was lower than that of PCT (82.2％ vs.93.3％).The combination AUC of sST2 and PCT was 0.944.Conclusions Serum sST2 has a certain value in the diagnosis of sepsis,and can be used to predict the prognosis of patients with sepsis.The higher the sST2 value,the worse the prognosis.Compared with PCT,sST2 is more sensitive in the prognosis of sepsis,but the specificity is not high enouph.The measurement of sST2 level coupled with PCT level may be more useful.