Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916, Barcelona, Spain.
Eur J Clin Microbiol Infect Dis. 2012 May;31(5):825-33. doi: 10.1007/s10096-011-1381-0. Epub 2011 Aug 26.
The aim of this study was to investigate whether procalcitonin (PCT), neopterin, C-reactive protein (CRP), and mid regional pro-atrial natriuretic peptide (MR-proANP) levels at admission and during the clinical course can be useful for the management of patients with pneumonia. The study population consisted of 75 patients with clinical and radiological diagnosis of pneumonia. Serum samples were collected at admission and during hospitalization. Complications were defined as intensive care unit (ICU) admission or death. The levels of PCT were significantly higher in pneumonia of definite bacterial origin in comparison to probable bacterial or unknown origin. The PCT levels were higher in pneumococcal pneumonia. The PCT and MR-proANP levels increased significantly according to the Pneumonia Severity Index (PSI). All biomarkers levels are higher in patients developing complications and who were dying. The serial levels of MR-proANP remain significantly elevated in patients developing complications and in patients classified in PSI and CURB-65 risk groups. In patients not developing complications, there is a significant decrease in the PCT levels. PCT can be useful for identifying pneumonia etiology. PCT and MR-proANP levels correlate with pneumonia severity rules. PCT and MR-proANP serial measurements can be useful for predicting short-term prognosis. Systemic biomarkers can provide additional information regarding clinical evolution, because these are dynamic and can be measured daily.
本研究旨在探讨入院时和住院期间降钙素原（PCT）、新蝶呤、C 反应蛋白（CRP）和中段心房利钠肽原（MR-proANP）水平是否对肺炎患者的管理有用。研究人群包括 75 例临床和影像学诊断为肺炎的患者。入院时和住院期间采集血清样本。并发症定义为入住重症监护病房（ICU）或死亡。与可能的细菌性或未知细菌性起源的肺炎相比，明确细菌性起源的肺炎中 PCT 水平显著升高。PCT 水平在肺炎链球菌性肺炎中更高。根据肺炎严重指数（PSI），PCT 和 MR-proANP 水平显著升高。所有生物标志物水平在发生并发症和死亡的患者中更高。在发生并发症和在 PSI 和 CURB-65 风险组中分类的患者中，MR-proANP 的连续水平仍然显著升高。在未发生并发症的患者中，PCT 水平显著下降。PCT 可用于确定肺炎病因。PCT 和 MR-proANP 水平与肺炎严重程度规则相关。PCT 和 MR-proANP 的连续测量可用于预测短期预后。系统生物标志物可提供有关临床演变的额外信息，因为这些标志物是动态的，可以每天测量。
