Fouda Ossama M, Elatar Sayed L
Medical Department, Mansoura University, Mansoura, Egypt.
Saudi Med J. 2010 Aug;31(8):887-90.
To study the relation between severity of pneumonia and serum cortisol level in a cohort of Egyptian patients.
All consecutive adult patients with community acquired pneumonia (CAP) admitted to Mansoura University Hospital, Mansoura, Egypt between March 2008 and December 2008 were considered for study inclusion. Exclusion criteria were patients with HIV infection, impaired immune systems, collagen vascular disease, interstitial pneumonia, chronic obstructive pulmonary disease (COPD), asthma requiring 10 mg of prednisolone at least daily, active malignant neoplasm, congestive heart failure (CHF), liver cirrhosis, or other causes of hypoproteinemia and septic shock. Pneumonia severity was scored at hospital admission according to pneumonia severity index (PSI) using the PORT criteria. The serum total cortisol was measured at hospital admission using ELISA.
The present study comprised 23 adult patients with CAP: 14 male and 9 females with a mean age of 47 +/- 16.7 years. Total serum cortisol (mean 483.11 +/- 387.91 nmol/L) was positively correlated (p=0.012, R=0.576) with pneumonia severity as assessed by the PSI. Moreover, the total serum cortisol levels showed significantly negative correlation with arterial oxygen tension (R=-0.500, p=0.035), oxygen saturation % (R=0.450, p=0.029), and bicarbonate level (R=0.266, p=0.03), as well as a significant positive correlation with the extent of lung involvement (p=0.041).
Total serum cortisol showed a significantly positive correlation with the severity of CAP assessed by the PORT index (PSI) in our study population. A single measurement of total serum cortisol may provide helpful information as the complex 20-variables, which are used in pneumonia severity index.
研究一组埃及患者中肺炎严重程度与血清皮质醇水平之间的关系。
纳入2008年3月至2008年12月期间连续入住埃及曼苏拉曼苏拉大学医院的所有社区获得性肺炎（CAP）成年患者。排除标准为HIV感染患者、免疫系统受损患者、胶原血管病患者、间质性肺炎患者、慢性阻塞性肺疾病（COPD）患者、至少每日需要10 mg泼尼松龙的哮喘患者、活动性恶性肿瘤患者、充血性心力衰竭（CHF）患者、肝硬化患者或其他低蛋白血症和感染性休克原因的患者。入院时根据肺炎严重程度指数（PSI）采用PORT标准对肺炎严重程度进行评分。入院时使用酶联免疫吸附测定法（ELISA）测量血清总皮质醇。
本研究包括23例CAP成年患者：14例男性和9例女性，平均年龄为47±16.7岁。血清总皮质醇（平均483.11±387.91 nmol/L）与通过PSI评估的肺炎严重程度呈正相关（p = 0.012，R = 0.576）。此外，血清总皮质醇水平与动脉血氧张力（R = -0.500，p = 0.035）、血氧饱和度%（R = 0.450，p = 0.029）和碳酸氢盐水平（R = 0.266，p = 0.03）呈显著负相关，与肺部受累程度呈显著正相关（p = 0.041）。
在我们的研究人群中，血清总皮质醇与通过PORT指数（PSI）评估的CAP严重程度呈显著正相关。血清总皮质醇的单次测量可能提供有用信息，如同肺炎严重程度指数中使用的复杂的20变量一样。
