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ɉɪɟɫɟɩɫɢɧ ± ɧɨɜɵɣ ɦɚɪɤɟɪ ɫɟɩɫɢɫɚ Ɋɟɡɭɥɶɬɚɬɵ ɦɟɠɞɭɧɚɪɨɞɧɵɯ ɢ ɨɬɟɱɟɫɬɜɟɧɧɵɯ ɤɥɢɧɢɱɟɫɤɢɯ ɢɫɩɵɬɚɧɢɣ ǪȍȓȤȒȖȊ ǪǪ ǯǨǶ ©ǬǰǨDzǶǵª ;9,,, Ɏɨɪɭɦ ©ɇɚɰɢɨɧɚɥɶɧɵɟ ɞɧɢ ɥɚɛɨɪɚɬɨɪɧɨɣ ɦɟɞɢɰɢɧɵ Ɋɨɫɫɢɢ ± 2014» Ɉɛɳɟɪɨɫɫɢɣɫɤɚɹ ɧɚɭɱɧɨ-ɩɪɚɤɬɢɱɟɫɤɚɹ ɤɨɧɮɟɪɟɧɰɢɹ ɫ ɦɟɠɞɭɧɚɪɨɞɧɵɦ ɭɱɚɫɬɢɟɦ ©Ɍɟɯɧɨɥɨɝɢɱɟɫɤɢɣ ɩɪɨɝɪɟɫɫ ɜ ɥɚɛɨɪɚɬɨɪɧɨɣ ɦɟɞɢɰɢɧɟ Ʉɥɢɧɢɱɟɫɤɢɟ ɩɟɪɫɩɟɤɬɢɜɵ ɢ ɷɤɨɧɨɦɢɱɟɫɤɢɟ ɩɪɟɞɟɥɵª 1- ɨɤɬɹɛɪɹ ɝ

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  • 2014»

    -

    1-

  • T-

    , ,

    -

    IL-4, IL-10, IL-11, IL-13, IL-1RA, sTNFR, TGF

    TNF, IL-1, IL-6, IL-8, IL-12, PAF, HMG-1, MIF

    IL-2, IFN, G-CSF

    -

    mCD14

  • LPS LBP

    LPS

    Bacteria

    LPS

    mCD 14

    MONOCYTE

    TNF-A

    mCD14 - -

    - .

  • LPS LBP

    LPS

    Bacteria

    LPS

    LBP LPS

    mCD 14

    MONOCYTE

    soluble CD14

    TNF-A

    mCD14

    sCD14 (s soluble

  • LPS LBP

    LPS

    ENDOTHELIAL CELL

    Bacteria

    LPS

    LBP LPS

    mCD 14

    MONOCYTE

    soluble CD 14

    TNF-A

    sCD14

    mCD14

  • LPS LBP

    LPS

    ENDOTHELIAL CELL

    Bacteria

    LPS

    LBP LPS

    mCD 14

    MONOCYTE

    soluble CD 14

    TNF-A

    sCD 14-ST Presepsin

    sCD14

    D

    ( D) sCD14 c ( ) sCD14-ST -

  • Meisner M. J Lab Med. 1999 23(5):263-272 Nakamura M, et al. Crit Care 2008, 12(Suppl 2):P194

    -

    -6

    -10

    -

  • Shozushima T, Takahashi G, Matsumoto N et al. Usefulness of presepsin (sCD14-ST) measurements as a marker for the diagnosis and severity of sepsis that satisfied diagnostic criteria of systemic inflammatory response syndrome. J Infect Chemother. 2011;17(6):764-9.

  • Liu B, Chen YX, Yin Q et al, Diagnostic value and prognostic evaluation of Presepsin for sepsis in an emergency department. Crit Care. 2013 Oct 20;17(5):R244.

  • APACHE II SOFA

    APACHE II SOFA

    Kojika M, Takahashi G, Matsumoto N, et al: Serum levels of soluble CD14 subtype reflect the APACHE II and SOFA scores. Med Postgrad. 2010; 48: 46-50.

    SOFA -

    APACHE II -

  • + -

    2 881 437 2 641 370

    % 95,5% 77,8%

    -

    , 600

    ,

    IL-6, 100

    % - % - % -

    + 95,5 21/22 95,5 21/22 100 22/22

    - 77,8 28/36 86,1 31/36 88,9 32/36

    +/- 94,7 18/19 94,7 18/19 89,5 17/19

    -

    100 1/1 100 1/1 100 1/1

    89,2 33/37 75,7 28/37 67,6 25/37

    87,8 101/115 86,1 99/115 84,3 97/115

    Endo S et al., Usefulness of presepsin in the diagnosis of sepsis in a multicenter prospective study. J Infect Chemother. 2012 Jun 13.

  • 600 pg/mL 0.5 ng/mL

    Ratio n Ratio n

    - 100% 19/19 68.4% 13/19

    95.0% 19/20 50.0% 10/20

    100% 4/4 50.0% 2/4

    97.6% 42/43 58.1% 25/43

    2857 (n=19)

    1488 (n=20)

    1464 (n=4) 0.961

    (n=19) 0.670 (n=20)

    0.424 (n=4)

    (n=43),

    .

    Fukui Y, et al. Poster of Sepsis 2013

    - -

  • +

    Sample: EDTA plasma sample collected before or after blood culture positive

    -

    Reference: LSI medience in-house evaluation result

  • Liu B, Chen YX, Yin Q et al, Diagnostic value and prognostic evaluation of Presepsin for sepsis in an emergency department. Crit Care. 2013 Oct 20;17(5):R244.

  • APACHE II

    630 100% 98% 0,494 87% 97%

    .

    Vodnik T et al., Presepsin (sCD14-ST) in preoperative diagnosis of abdominal sepsis . Clin Chem Lab Med. 2013 Jun 5:1-10.

  • ,

    -

    -35

    - 66%, - - 0,79;

    - 20%».

    1 -

    2

    3 -

  • ~

    38

    (281 )

    (0,98 )

    .

    Shozushima T, Takahashi G, Matsumoto N et al. Usefulness of presepsin (sCD14-ST) measurements as a marker for the diagnosis and severity of sepsis that satisfied diagnostic criteria of systemic inflammatory response syndrome. J Infect Chemother. 2011;17(6):764-9.

  • Shozushima T, Takahashi G, Matsumoto N et al. Usefulness of presepsin (sCD14-ST) measurements as a marker for the diagnosis and severity

    of sepsis that satisfied diagnostic criteria of systemic inflammatory response syndrome. J Infect Chemother. 2011;17(6):764-9.

  • 26 (70%)

    11 (30%).

    et al. Evaluation of soluble CD14 subtype (presepsin) in burn sepsis.

    Burns. 2013 Sep 26. [Epub ahead of print]

  • .

    20-

    30- 63%

    -

    :

    - , ,

    -

    (AUC~ 0.9)

    647 47%

    899 55%

    . Ishikura H et al, New diagnostic strategy for sepsis-induced disseminated intravascular coagulation: a prospective single-center observational study. Crit Care. 2014 Jan 20;18(1):R19.

  • Chiesa C et al. C reactive protein and procalcitonin: Reference intervals for preterm and term newborns during the early neonatal period Clinica Chimica Acta 412 (2011) 1053 1059

  • 26

    643,1 SD 303,8

    578

    -

    - .

    .

    Mussap M. et al. Soluble CD14 subtype (sCD14-ST) presepsin in critically ill preterm newborns: preliminary reference ranges. J Matern Fetal Neonatal Med. 2012 ;25(Suppl 5):51-3.

  • 18 -

    - 556 ± 158

    - 1772 ± 1009

    presepsin concentration in neonatal whole blood

    may be usefulness in diagnosis of early-

    Kwiatkowska-Gruca M et al. Presepsyna (rozpuszczalny podtyp CD14-ST) jako diagnostyczny biomarker

    posocznicy u noworodków. Pediatria Polska 88, 5 , 392-397, September 2013

  • AUC ROC

    1- 0,97 0,90 0,68

    2- 0,98 0,92 0,75

    3- 0,98 0,93 0,77

    - 781 ; 0,5 ,

    .

    -

    ,

    -

    .

  • 18 1-167 .), ,

    38 , 30

    PRESEPSIN (sCD14-ST) MEASURED IN CEREBROSPINAL FLUID IN CHILDREN WITH SUSPECTED BACTERIAL VENTRICULITIS/MENINGITIS WITH INSTALLED EXTERNAL VENTRICULAR DRAINAGE TO REDUCE RAISED INTRACRANIAL PRESSURE. A.N. Kopitar et al., 2014, in press.

  • - :

    - - 25-

    Shirakawa K. Diagnosis of Respiratory Tract Infectious Disease using urine specimens.

    European Patent Application EP 2 711 710 A1

  • ,

  • 15 . 15 .

    28 . 28 .

    -

    .

    ».

    Novelli G et al., Pathfast Presepsin Assay for Early Diagnosis of Bacterial Infections in Surgical Patients: Preliminary Study. Transplant Proc. 2013 Sep;45(7):2750-3

  • 100

    1000

    10000

    100000

    48hr 96hr 144hr 15day

    Pres

    epsi

    n (p

    g/m

    L)

    Day100

    1000

    10000

    100000

    48hr 96hr 144hr 15day

    Pres

    epsin

    (pg/

    mL)

    Day

    A) Patient group administrated

    with optimal antibiotics (n=34)

    B) patient group changed Antibiotics n=16

    Transplant Proc. 2013 Sep;45(7):2750-3.

    Presepsin values decreased by the appropriate use of antibiotic.

    500 500

    28 day non-survivor

    *

    * *

    *

    Changing antibiotic

    Subject: Transplant and abdominal surgery patients who confirmed infection (positive blood culture) The transition of presepsin levels with patient group administrated with optimal antibiotic and changed antibiotic were shown in the following.

    Useful to monitor antibiotic application

    Patient died after 96hr (48hr: 1245pg/mL, 96hr: 1845pg/mL)

  • - (n=27) (n=26)

    SOFA

    -6

    -

    -

    -

    -

    -

    -

    -

    -

    103

    SOFA APACHE II

    -

    Endo S et al Presepsin as a powerful monitoring tool for the prognosis and treatment of sepsis: A multicenter prospective study. J Infect Chemother. 2013 Dec 1

  • Masson S et al. , Presepsin (soluble CD14 subtype) and procalcitonin levels for mortality prediction in sepsis: data from the Albumin Italian Outcome Sepsis trial. Crit Care. 2014 Jan

  • 50

    -

    - - 2269 (1171-4300) 18,5 (3,4-45,2)

    - - 1184 ( 875-2113) - 10,8 (2,7-41,9)

    Masson S et al. , Presepsin (soluble CD14 subtype) and procalcitonin levels for mortality prediction in sepsis: data from the Albumin Italian Outcome Sepsis trial. Crit Care. 2014 Jan

  • Trial registration. ClinicalTrials.gov NCT01535534. Registered 14 February 2012.

    AUC ROC - 0,72 0,84. sepsis, cutoff = 600 pg/ml;

    AUC 0,64 0,71. -

    -6

  • - .

    -

    -

    -

    . ., . ., . . -

  • -

    -

    ~ 16 -

    . ., . ., . . -

  • )

    Sargentini V et al. Presepsin as a potential marker for bacterial infection relapse in critical care patients. A preliminary study.[Clin Chem Lab Med 2014;

  • Sargentini V et al. Presepsin as a potential marker for bacterial infection relapse in critical care patients.

    A preliminary study. Clin Chem Lab Med 2014

  • ( - )

  • - -9.

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    2014

  • . ., . ., . ., . ., . ., . .

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  • .

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  • 17.02 199 24 355 9,67 13,3 11 093

    18.02 411 -

    19.02 233 1 875 16,1 1 253

    24.02 456 1 361 202

    27.02 350 992 8,3 353

    04.03 557 1 041 262

    E. coli

  • -

    11.03 439 9,5

    620

    639

    13.03 1059 11,3

    14.03 2138

    17.03 878

    18.03 1211

    19.03 1101 28,6

  • -

  • September 21-22, 2014

  • September 21-22, 2014

    Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes

    Klinik für Thorax- und Herz-Gefäßchirurgie

  • 62

    30- APACHE II > 25

    (

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    200

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    6.

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  • hsTnI - ,

    50 000 / CV< 10%,

    hs -

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    Mitsubishi Chemical Medience Corporation,

    PATHFAST®

  • www.presepsintest.ru

  • \ : (495) 980 6679

    -78-10, 975-78-11

    \ : (495) 975-78-12

    [email protected] www.diakonlab.ru