DIJAGNOSTIČKO SLAGANJE PRESEPSINA, PROKALCITONINA, C-REAKTIVNOG PROTEINA I BROJA LEUKOCITA KOD PACIJENATA SA SUMNJOM NA SEPSU
Sažetak
Cilj: Kada se kod pacijenta sa sumnjom na sepsu naiđe na različite vrednosti inflamatornih parametara važno je znati o tome kakva je saglasnost između njih u cilju postavljanja dijagnoze. Cilj naše studije bio je da testiramo slaganje između četiri najčešće korišćena testa za dijagnostikovanje sistemske infekcije: broja belih krvnih zrnaca (VCC). ), serumskih nivoa C-reaktivnog proteina (CRP), prokalcitonina i presepsina.
Metode: Ovom studijom preseka obuhvaćeno je 479 odraslih pacijenata hospitalizovanih u Univerzitetskom kliničkom centru Kragujevac tokom 2022. godine, za koje se sumnjalo da imaju sistemsku infekciju, a čije su mikrobiološke analize bile pozitivne.
Rezultati: Na uzorku bolničkih pacijenata sa izolovanim bakterijama sa mesta sumnje na infekciju, parametri inflamacije su pokazali nisku saglasnost kada su korišćeni za dijagnostiku sistemske infekcije. Samo serumski nivoi presepsina su pokazali značajan nivo slaganja sa CRP-om i prokalcitoninom (Cohen-ova kapa = 0,257, p = 0,000 Cohen-ova kapa = 0,169, p = 0,000, respektivno, ali sa niskim kapa vrednostima, dok je slaganje između CRP-a i prokalcitonina takođe bilo beznačajno kao između broja belih ćelija i sva ostala tri parametra.
Zaključci: Kada se kod pacijenta sa sumnjom na sepsu nađu različite vrednosti parametara inflamacije, odluka o antibiotskoj terapiji treba da se zasniva na bilo kom od dva para parametara - presepsin/C-reaktivni protein ili presepsin/prokalcitonin.
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