This study aimed to investigate the possible relationship between the two biomarkers presepsin and procalcitonin (PCT) and monocyte immune function, and to explore their combination in mortality prediction in the early stage of sepsis. A total of 198 patients with bacterial infection and diagnosed with sepsis and 40 healthy control subjects were included. Blood samples were collected on admission within 24 h. Plasma concentrations of presepsin and PCT were measured. Expression of monocyte surface CD14, programmed cell death receptor ligand-1 (PD-L1) and human leucocyte Ag (HLA)-DR were determined using flow cytometry. Levels of plasma presepsin and PCT were significantly higher under septic conditions, and increased with the progression of sepsis. Monocyte CD14 and HLA-DR expression were decreased, while PD-L1 was overexpressed in sepsis compared to control. Presepsin and PCT concentrations were positively correlated with Sequential Organ Failure Assessment score, Acute Physiology and Chronic Health Evaluation System II score and PD-L1, while they were negatively correlated with CD14 and HLA-DR. Presepsin plus monocyte HLA-DR mean fluorescence intensity had the highest prognostic value over other parameters alone or in combination. Presepsin and PCT had a weak correlation with monocyte dysfunction during early sepsis. The combination of presepsin and monocyte HLA-DR could help improve prognostic value.

本研究旨在探讨两种生物标志物前蛋白酶和降钙素原 (PCT) 与单核细胞免疫功能之间的可能关系，并探讨它们在脓毒症早期死亡率预测中的组合。共纳入 198 名细菌感染并诊断为败血症的患者和 40 名健康对照受试者。入院24小时内采集血样。测量了预蛋白酶和 PCT 的血浆浓度。使用流式细胞术测定单核细胞表面 CD14、程序性细胞死亡受体配体-1 (PD-L1) 和人类白细胞抗原 (HLA)-DR 的表达。在脓毒症条件下，血浆 presepsin 和 PCT 的水平显着升高，并随着脓毒症的进展而增加。单核细胞 CD14 和 HLA-DR 表达降低，而与对照组相比，PD-L1 在脓毒症中过度表达。Presepsin 和 PCT 浓度与顺序器官衰竭评估评分、急性生理学和慢性健康评估系统 II 评分和 PD-L1 呈正相关，而与 CD14 和 HLA-DR 呈负相关。Presepsin 加单核细胞 HLA-DR 平均荧光强度比单独或组合的其他参数具有最高的预后价值。Presepsin 和 PCT 与早期脓毒症的单核细胞功能障碍相关性较弱。Presepsin 和单核细胞 HLA-DR 的组合有助于提高预后价值。而它们与 CD14 和 HLA-DR 呈负相关。Presepsin 加单核细胞 HLA-DR 平均荧光强度比单独或组合的其他参数具有最高的预后价值。Presepsin 和 PCT 与早期脓毒症的单核细胞功能障碍相关性较弱。Presepsin 和单核细胞 HLA-DR 的组合有助于提高预后价值。而它们与 CD14 和 HLA-DR 呈负相关。Presepsin 加单核细胞 HLA-DR 平均荧光强度比单独或组合的其他参数具有最高的预后价值。Presepsin 和 PCT 与早期脓毒症的单核细胞功能障碍相关性较弱。Presepsin 和单核细胞 HLA-DR 的组合有助于提高预后价值。