Lee Kwangha, Huh Jin Won, Lim Chae-Man, Koh Younsuck, Hong Sang-Bum
From the Department of Internal Medicine, Pusan National University School of Medicine.
Scand J Infect Dis. 2013 Oct;45(10):760-5. doi: 10.3109/00365548.2013.797600. Epub 2013 Jun 9.
We measured serum levels of pre-B cell colony-enhancing factor (PBEF), which has been suggested as a novel biomarker of sepsis and acute respiratory distress syndrome (ARDS), and evaluated its use as a prognostic biomarker.
PBEF was measured in 104 adult ventilated patients who were diagnosed with sepsis upon admission using an enzyme-linked immunosorbent assay.
The mean age of our patients was 62.9 ± 12.1 y, and 62 (59.6%) patients were male. The median PBEF level was 5.4 ng/ml (range 1.1-150.7 ng/ml). Non-survivors (n = 57) demonstrated significantly higher PBEF levels than survivors (18.7 ± 34.5 vs 6.9 ± 6.1 ng/ml; p = 0.022). Most particularly, patients with PBEF levels ≥ 10.4 ng/ml (n = 27) demonstrated higher hospital mortality than patients with PBEF levels < 10.4 ng/ml (n = 77) (74.1% vs. 48.1%; p = 0.025). Univariate logistic analysis determined PBEF ≥ 10.4 ng/ml to be an independent factor associated with hospital survival (hazard ratio = 0.324, 95% confidence interval = 0.123-0.854; p = 0.023). Among patients with sepsis-induced ARDS (n = 59), non-survivors (n = 35) demonstrated significantly higher PBEF levels than survivors (n = 24), but not interleukin-6 (IL-6) levels.
Our findings indicate that high PBEF is associated with poor clinical outcomes in ventilated patients with sepsis and sepsis-induced ARDS. Serum PBEF might be a better predictor of mortality than IL-6 in patients with sepsis-induced ARDS.
我们检测了前B细胞集落增强因子（PBEF）的血清水平，该因子被认为是脓毒症和急性呼吸窘迫综合征（ARDS）的一种新型生物标志物，并评估了其作为预后生物标志物的用途。
使用酶联免疫吸附测定法对104例入院时被诊断为脓毒症的成年通气患者检测PBEF。
我们患者的平均年龄为62.9±12.1岁，62例（59.6%）为男性。PBEF水平中位数为5.4 ng/ml（范围1.1 - 150.7 ng/ml）。非幸存者（n = 57）的PBEF水平显著高于幸存者（18.7±34.5 vs 6.9±6.1 ng/ml；p = 0.022）。最特别的是，PBEF水平≥10.4 ng/ml的患者（n = 27）的医院死亡率高于PBEF水平<10.4 ng/ml的患者（n = 77）（74.1%对48.1%；p = 0.025）。单因素逻辑分析确定PBEF≥10.4 ng/ml是与医院生存相关的独立因素（风险比=0.324，95%置信区间=0.123 - 0.854；p = 0.023）。在脓毒症诱导的ARDS患者（n = 59）中，非幸存者（n = 35）的PBEF水平显著高于幸存者（n = 24），但白细胞介素-6（IL-6）水平并非如此。
我们的研究结果表明，高PBEF与脓毒症及脓毒症诱导的ARDS通气患者的不良临床结局相关。在脓毒症诱导的ARDS患者中，血清PBEF可能是比IL-6更好的死亡率预测指标。
