Lacoma Alicia, Bas Albert, Tudela Pere, Giménez Montse, Mòdol Josep Maria, Pérez Miguel, Ausina Vicente, Dominguez Jose, Prat-Aymerich Cristina
Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autonòma de Barcelona, Badalona, Spain; CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Spain.
Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autonòma de Barcelona, Badalona, Spain.
Enferm Infecc Microbiol Clin. 2014 Mar;32(3):140-6. doi: 10.1016/j.eimc.2013.07.006. Epub 2013 Sep 19.
To assess the correlation of procalcitonin (PCT), C-reactive protein (CRP), neopterin, mid-regional pro-atrial natriuretic peptide (MR-proANP), and mid-regional pro-adrenomedullin (MR-proADM) with severity risk scores: severe CAP (SCAP) and SMART-COP in patients with community-acquired pneumonia (CAP), as well as short term prognosis and to determine the correlation with mortality risk scores.
Eighty-five patients with a final diagnosis of pneumonia were consecutively included during a two month period. Epidemiological, clinical, microbiological, and radiological data were recorded. Patients were stratified according to the PSI, CURB-65, SCAP and SMART-COP. Complications were defined as respiratory failure/shock, need of ICU, and death. Plasma samples were collected at admission.
MR-proANP and MR-proADM showed significantly higher levels in high risk SCAP group in comparison to low risk. When considering SMART-COP none of the biomarkers showed statistical differences. MR-proADM levels were high in patients with high risk of needing intensive respiratory or vasopressor support according to SMRT-CO. Neopterin and MR-proADM were significantly higher in patients that developed complications. PCT and MR-proADM showed significantly higher levels in cases of a definite bacterial diagnosis in comparison to probable bacterial, and unknown origin. MR-proANP and MR-proADM levels increased statistically according to PSI and CURB-65.
Biomarker levels are higher in pneumonia patients with a poorer prognosis according to SCAP and SMART-COP indexes, and to the development of complications.
评估降钙素原（PCT）、C反应蛋白（CRP）、新蝶呤、中段心房利钠肽原（MR-proANP）和中段肾上腺髓质素原（MR-proADM）与社区获得性肺炎（CAP）患者的严重程度风险评分：重症CAP（SCAP）和SMART-COP的相关性，以及短期预后，并确定与死亡风险评分的相关性。
在两个月期间连续纳入85例最终诊断为肺炎的患者。记录流行病学、临床、微生物学和放射学数据。根据PSI、CURB-65、SCAP和SMART-COP对患者进行分层。并发症定义为呼吸衰竭/休克、需要入住重症监护病房（ICU）和死亡。入院时采集血浆样本。
与低风险组相比，高风险SCAP组的MR-proANP和MR-proADM水平显著更高。在考虑SMART-COP时，没有一种生物标志物显示出统计学差异。根据SMRT-CO，需要强化呼吸或血管活性药物支持的高风险患者的MR-proADM水平较高。发生并发症的患者新蝶呤和MR-proADM显著更高。与可能的细菌感染和不明来源相比，确诊为细菌感染的患者PCT和MR-proADM水平显著更高。MR-proANP和MR-proADM水平根据PSI和CURB-65有统计学意义的升高。
根据SCAP和SMART-COP指数以及并发症的发生情况，预后较差的肺炎患者生物标志物水平更高。
