Sardà Sánchez Marta, Hernández Joan Calzada, Hernández-Bou Susanna, Teruel Gemma Claret, Rodríguez Jesús Velasco, Cubells Carles Luaces
Emergency Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Passeig Sant Joan de Déu 2, Esplugues de Llobregat, Barcelona, Spain.
BMC Res Notes. 2012 Jul 20;5:363. doi: 10.1186/1756-0500-5-363.
In adult population with community acquired pneumonia high levels of pro-adrenomedullin (pro-ADM) have been shown to be predictors of worse prognosis. The role of this biomarker in pediatric patients had not been analyzed to date. The objective of this study is to know the levels of pro-ADM in children with community acquired pneumonia (CAP) and analyze the relation between these levels and the patients' prognosis.
Prospective observational study including patients attended in the emergency service (January to October 2009) admitted to hospital with CAP and no complications at admission. The values for pro-ADM were analyzed in relation to: need for oxygen therapy, duration of oxygen therapy, fever and antibiotic therapy, complications, admission to the intensive care unit, and length of hospital stay. Fifty patients were included. Ten presented complications (7 pleural effusion). The median level of pro-ADM was 1.0065 nmol/L (range 0.3715 to 7.2840 nmol/L). The patients presenting complications had higher levels of pro-ADM (2.3190 vs. 1.1758 nmol/L, p = 0.013). Specifically, the presence of pleural effusion was associated with higher levels of pro-ADM (2.9440 vs. 1.1373 nmol/L, p < 0.001).
In our sample of patients admitted to hospital with CAP, pro-ADM levels are related to the development of complications during hospitalization.
在社区获得性肺炎的成年人群中，高水平的前肾上腺髓质素（pro-ADM）已被证明是预后较差的预测指标。迄今为止，这种生物标志物在儿科患者中的作用尚未得到分析。本研究的目的是了解社区获得性肺炎（CAP）患儿的pro-ADM水平，并分析这些水平与患者预后之间的关系。
前瞻性观察性研究，纳入2009年1月至10月在急诊就诊并因CAP入院且入院时无并发症的患者。分析了pro-ADM值与以下因素的关系：氧疗需求、氧疗持续时间、发热和抗生素治疗、并发症、入住重症监护病房以及住院时间。共纳入50例患者。10例出现并发症（7例胸腔积液）。pro-ADM的中位数水平为1.0065 nmol/L（范围0.3715至7.2840 nmol/L）。出现并发症的患者pro-ADM水平较高（2.3190对1.1758 nmol/L，p = 0.013）。具体而言，胸腔积液的存在与较高的pro-ADM水平相关（2.9440对1.1373 nmol/L，p < 0.001）。
在我们因CAP入院的患者样本中，pro-ADM水平与住院期间并发症的发生有关。
