ririРаны и раневые инфекции. Журнал имени проф. Б.М. КостючёнкаWounds and wound infections. The prof. B.M. Kostyuchenok journal2408-96132500-0594Regional non-governmental organization “Surgical society - Wounds and wound infections”10.25199/2408-9613-2018-6-1-34-38riri-170Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL REPORTSБиомаркеры при проведении интенсивной терапии сепсисаBiomarkers during intensive care for sepsisЗвягинА. А.ZvyaginA. A.

119997, Москва, ул. Бол. Серпуховская, 27

27, Bol’shaya Serpukhivskaya Str., Moscow, 117997

ДемидоваВ. С.DemidovaV. S.

Валентина Семеновна Демидова

119997, Москва, ул. Бол. Серпуховская, 27

27, Bol’shaya Serpukhivskaya Str., Moscow, 117997

demidova@ixv.ruСмирновГ. В.SmirnovG. V.

27, Bol’shaya Serpukhivskaya Str., Moscow, 117997

ФГБУ «НМИЦ хирургии им. А. В. Вишневского» Минздрава РоссииРоссияFSGI "A. V. Vishnevsky National Medical Research Center of surgery" Ministry of Health of RussiaRussian Federation201907052019613438Copyright © Звягин А.А., Демидова В.С., Смирнов Г.В., 20192019Звягин А.А., Демидова В.С., Смирнов Г.В.Zvyagin A.A., Demidova V.S., Smirnov G.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.riri.su/jour/article/view/170

В статье представлены результаты проспективного одноцентрового обсервационного клинического исследования, в ходе которого сравнивали уровни биомаркеров у больных сепсисом.

Цель исследования

Цель исследования: оценить в динамике уровень пресепсина, прокальцитонина и C-реактивного белка в двух группах: умершие и выжившие больные сепсисом.

Материалы и методы исследования. В исследование последовательно включен 41 пациент с диагнозом «сепсис» (исходя из концепции «Сепсис-3») с разделением на две группы: группа 1 (21 человек) – выжившие, группа 2 (20 человек) – умершие. Больным обеих групп проводили общепринятую интенсивную терапию сепсиса. Помимо стандартного лабораторно-инструментального обследования, у пациентов в динамике проводили контроль уровня пресепсина, прокальцитонина, С-реактивного белка.

Результаты исследования

Результаты исследования. Средний уровень пресепсина в группе 1 составил 1718,00 pg/ml, в группе 2 – 3266,50 pg/ml, при этом половина значений находятся в пределах Me (25,75) 1021,00–3231,00 и 1618,50–7469,00 pg/ml. Средний уровень прокальцитонина в группах 1 и 2 – 0,995 и 4,465 ng/ml соответственно, при этом Me (25,75) 0,49–4,44 и 1,625–19,30 ng/ml. Средний уровень С-реактивного белка в этих группах – 95,5 и 215,0 mg/l соответственно, при этом Me (25,75) 64,00–155,00 и 155,00–264,00 mg/l. При сравнении значений биомаркеров в двух группах пациентов выявлены достоверные различия (p-value для пресепсина, прокальцитонина и для С-реактивного белка равны соответственно 0,000008, 0,000242, 0,0000001).

Заключение

Заключение. Уровни С-реактивного белка (CRP), прокальцитонина (PCT) и пресепсина (P-SEP) у больных сепсисом достоверно отличаются в группах с благоприятным и неблагоприятным исходом лечения. Выявлено достоверное повышение уровней всех исследованных биомаркеров в группе пациентов с неблагоприятным исходом лечения. Одновременное определение в динамике уровня нескольких биологических маркеров сепсиса позволяет наиболее полно оценивать эффективность проводимой интенсивной терапии и прогнозировать исход заболевания.

The article presents the results of a prospective, single-center observational clinical trial, in which biomarker levels were compared in patients with sepsis.

Objective

Objective: to evaluate the dynamics of the level of presepsin, procalciotonin and C-reactive protein in two groups - the dead and the surviving patients with sepsis.

Materials and methods

Materials and methods. The study consistently included 41 patients with a diagnosis of sepsis (based on the concept of "Sepsis-3"), divided into two groups: group 1 (21 people) – survivors, group 2 (20 people) – dead. Patients in both groups received conventional intensive therapy for sepsis. In addition to the standard laboratory and instrumental examination, patients in the dynamics were monitored for the level of presepsin, procalcitonin, C-reactive protein.

Results

Results. The average level of presepsin in group 1 and group 2 was 1718.00 and 3266.50 pg/ml, respectively, with half of the values being within (Me (25.75) 1021.00–3231.00 and 1618.50–7469.00 pg/ml. The average level of procalcitonin in group 1 and group – 0.995 and 4.465 ng/ml, respectively, while Me (25.75) 0.49–4.44 and 1.625–19.30 ng/ml. The average level of C-reactive protein in group No. 1 and group No. 2 is 95.5 and 215.0 mg/l, respectively, with Me (25.75) 64.00–155.00 and 155.00–264.00 mg/l. When comparing the values of biomarkers in the two groups of patients, significant differences were found (p-value for presepsin, procalсitonina and C-reactive protein are, respectively 0.000008, 0.000242, 0.0000001).

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The authors declare that there are no conflicts of interest present.