Terapevticheskii arkhivTerapevticheskii arkhiv0040-36602309-5342LLC Obyedinennaya Redaktsiya3287610.26442/terarkh201890114-47Research ArticleThe role of presepsin in the diagnosis and assessment of severity of sepsis and severe pneumoniaTItovaE Atea6419@yandex.ruEyrikhA R-TitovaZ A-Subdepartment of therapy and general medical practice with course of further professional education of the Altai State Medical UniversityAltai Regional Clinical Hospital151120189011444711042020Copyright © 2018, Consilium Medicum2018The aim of this study was to evaluate marker of inflammation presepsin to improve diagnosis of severe pneumonia, sepsis. Materials and methods. 75 patients with pneumonia, sepsis, other inflammatory diseases aged from 17 to 78 years were examined. These patients have been investigated for the level of the presepsin. Presepsin level was quantified on immunohemilyuministsentny analyzer Pathfast (Mitsubishi Chemical Medience Corporation, Japan) in pg/ml. All patients had obtained an antibacterial therapy in other health care organizations before entering the hospital. Results. Presepsin at the general group of patients with pneumogenic sepsis was 3196.9±1202.16 pg/mL (n=14, x̅±m), with abdominal sepsis - 2506.7±448.32 pg/mL (n=28), with other inflammatory diseases - 671.6±124.55 pg/mL (n=11). Presepsin of patients with pneumogenic sepsis was 1125.3±240.59 pg/mL (n=3), presepsin of patients with severe pneumonia was - 362.6±76.29 pg/mL (n=13, p<0.05), non-severe pneumonia - 157.3±33.02 pg/mL (n=9, p<0.05). Conclusion. The high level of presepsin is an indication of an active infectious disease and reflects the severity of the pneumonia and development of sepsis. Keeping a high level against the backdrop of earlier presepsin ongoing antibiotic therapy is an indication of their lack of effectiveness. A significant variability of presepsin should be taken into account.presepsinpneumoniasepsisпресепсинпневмониясепсис[Чучалин А.Г. Биологические маркеры при респираторных заболеваниях. Терапевтический архив. 2014;3:4-13.][Вельков В.В. Использование биомаркера «Пресепсин» для ранней и высокоспецифической диагностики сепсиса. Клинические рекомендации. М.; 2014. Доступно по: http://www.fedlab.ru/upload/medialibrary/e5e/kochetov-ag.-klin-rek.-kld.-presepsin_-dek-2014.pdf Ссылка активна на 17.01.2018][Behnes M, Bertsch T, Lepiorz D, Lang S, Trinkmann F, Brueckmann M, Borggrefe M, Hoffmann U. Diagnostic and prognostic utility of CD 14 subtype (presepsin) for severe sepsis and septic shock during the first week of intensive care treatment. Critical Care. 2014;18:507. doi: 10.1186/s13054-014-0507-z][Чучалин А.Г., Синопальников А.И., Козлов Р.С., Авдеев С.Н., Тюрин И.Е., Руднов В.А., Рачина С.А., Фесенко О.В. Клинические рекомендации по диагностике, лечению и профилактике тяжелой внебольничной пневмонии у взрослых. - М., 2014. 82 с. Доступно по: http://mzdrav.rk.gov.ru/file/Klinicheskie_rekomendacii.pdf. Ссылка активна на 17.01.2018.][Shozushima T, Takahashi G, Matsumoto N, Kojika M, Okamura Y, Endo S. Usefulness of presepsin (sCD 14-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. doi: 10.1007/s10156-011-0254-x][Spanuth E, Wilhelm J, Loppnow H, et al. Utility of PATHFAST Presepsin in Septic Patients Admitted to the Emergency Room. 1st Central and Eastern European Sepsis Forum SepsEast Budapest, September 19-23, 2012.][Zhang J, Hu Z, Song J, Shao J. Diagnostic value of presepsin for sepsis. Medicine. 2015;94(47):e2158. doi: 0.1097/md.0000000000002158][Liu B, Yin Q, Chen Y.X, Zhao Y.Z, Li C.S. Role of Presepsin (sCD14-ST) and the CURB65 scoring system in predicting severity and outcome of community - acquired pneumonia in an emergency department. Respir Med. 2014;108(8):1204-13. doi: 10.1016/j.med.2014.05.005][Wu C.C, Lan H.M, Han S.T, Chaou C.H, Yeh C.F, Liu S.H, Li C.H, Blaney G.N 3rd, Liu Z.Y, Chen K.F. Comparison of diagnostic accuracy in sepsis between presepsin, procalcitonin, and C-reactive protein: a systematic review and meta - analysis. Ann Intensive Care. 2017;7:91. doi: 10.1186/s13613-017-0316-z][Klouche К, Cristol J.P, Devin J, Gilles V, Kuster N, Larcher R, Amigues L, Corne P, Jonquet O, Dupuy A.M. Diagnostic and prognostic value of soluble CD14 subtype (Presepsin) for sepsis and community - acquired pneumonia in ICU patients. Ann Intensive Care. 2016;6:59. doi: 10.1186/s13613-0160-6]