Department of Anaesthesia, Critical Care and Pain Medicine, Zhongshan Hospital of Fudan University, 180 Fenglin Road, Shanghai, 200032, PR China.
Heart Lung. 2013 Mar-Apr;42(2):139-45. doi: 10.1016/j.hrtlng.2012.11.005. Epub 2012 Dec 27.
The aim was to assess the diagnostic and prognostic value of measuring pentraxin 3 (PTX3) together with C-reactive protein (CRP) in patients with ventilator-associated pneumonia (VAP).
The PTX3 values increase rapidly during multiple inflammatory conditions, but little is known about its characteristics in VAP.
Measurement of PTX3 and CRP levels in plasma from 136 consecutive patients receiving mechanical ventilation > 48 h in a prospective single center study.
A PTX3 threshold of >16.43 ng/ml provided a specificity of 74.0% and a sensitivity of 68.6% for the diagnosis of VAP. PTX3 correlated with severity of sepsis and peaked earlier than CRP in patients with confirmed VAP. Multivariate Cox regression analysis showed PTX3 was the independent predictor for mortality of VAP.
PTX3 was not superior to CRP as a biomarker to diagnose VAP, but it was an early indicator of inflammation and had better prognostic value to predict mortality than CRP.
评估同时检测五聚素 3(PTX3)和 C 反应蛋白(CRP)在呼吸机相关性肺炎(VAP)患者中的诊断和预后价值。
PTX3 在多种炎症情况下会迅速升高,但关于其在 VAP 中的特征知之甚少。
前瞻性单中心研究中,对 136 例连续接受机械通气>48 小时的患者的血浆中 PTX3 和 CRP 水平进行测量。
PTX3 阈值>16.43ng/ml 对 VAP 的诊断具有 74.0%的特异性和 68.6%的敏感性。PTX3 与脓毒症的严重程度相关,并且在确诊 VAP 的患者中比 CRP 更早达到峰值。多变量 Cox 回归分析显示,PTX3 是 VAP 死亡率的独立预测因子。
PTX3 作为诊断 VAP 的生物标志物并不优于 CRP,但它是炎症的早期指标,其预后价值优于 CRP,可预测死亡率。