The efficacy of platelet monocyte aggregation expression levels in the clinical diagnosis of sepsis / 中华检验医学杂志

ABSTRACT

Objective:To evaluate the efficacy of platelet-monocyte aggregates (PMA) in the clinical diagnosis of sepsis.Methods:From January 2022 to December 2022, patients in the First Affiliated Hospital of Soochow University were recruited in this study, among which 41 were with sepsis (sepsis group), 41 patients had infection but were not diagnosed as sepsis (infection group), and 25 healthy individuals (healthy control group) were simultaneously chosen. Patients with sepsis were divided into the shock group (14 cases) and the non-shock group (27 cases). PMA of all subjects were measured by Beckman Coulter Navios Flow Cytometry and detection of procalcitonin(PCT), C-reactive protein (CRP) and platelet (PLT).The differences of the two indexes between the different groups were compared by nonparametric test. Spearman′s correlation test was used to analyze the correlation among PMA, PCT, CRP and PLT. The diagnostic value of PMA in sepsis was evaluated by drawing the receiver operating characteristic (ROC) curve. Kaplan-Meier survival curve was used to compare the survival time of patient with different PMA. Results:The PMA in the sepsis group, infection group and healthy control group were 52.66% (27.10%, 81.09%), 37.22% (26.52%, 54.56%) and 15.94% (15.10%, 17.02%), respectively. For the three groups, PCT levels were 3.10 (0.23, 15.35)μg/L, 0.15 (0.08, 0.79)μg/L and 0.02 (0.02, 0.02)μg/L, CRP levels were 106.6 (35.87, 175.60)mg/L, 76.45 (27.20, 110.10)mg/L and 1.26 (0.94, 2.42) mg/L, and the PLT counts were 116.00 (90.25, 204.30)×10 9/L, 192.00 (147.30, 333.00)×10 9/L and 199.50 (178.00, 252.80)×10 9/L. The values for PMA, PCT and CRP levels were significantly higher in the septic group compared to the healthy controls (the U values were 0.00, 5.00 and 1.00, P<0.001). But the PLT for the septic group was lower than that from the healthy control ( U=47.00, P<0.05). The differences in PCT and PLT were statistically (the U values were 84.50 and 176.50, P<0.05), but there was no significant difference between the PMA and CRP(the U values were 255.00 and 210.00, P>0.05) for the two groups. PMA was positively correlated with PCT( rs=0.562, P<0.001) and CRP( rs=0.447, P<0.001) in patients. The levels of PMA in shock and non-shock groups were 83.54% (76.51%, 86.82%) and 43.75% (21.59%, 62.83%) respectively ( U=12.00, P<0.05). The AUC of PMA in diagnostic of sepsis was 0.750(95% CI 0.657-0.843), the best cut-off value was 37.99%. Survival curve analysis showed that the survival time was significantly lower in the PMA≥37.99% group ( χ 2=4.805, P<0.05). Conclusion:PMA holds significant clinical reference for sepsis diagnosis and has the potential to serve as a biomarker in sepsis diagnostic procedures.