Department of Pediatrics, Medical Center of Postgraduate Education, 99/103 Marymoncka St., Warsaw, 01-813, Poland.
Adv Exp Med Biol. 2015;835:31-6. doi: 10.1007/5584_2014_41.
Copeptin has been associated with the severity of pneumonia and its complications. This study was designed to assess the usefulness of copeptin measurement in children with community-acquired pneumonia (CAP) and copeptin's relation with disease severity and sodium equilibrium. The study encompassed 311 patients (227 with pneumonia and 84 healthy controls) aged 8 days-18 years. Clinical findings and inflammatory markers were used to predict the disease severity. We found that the level of copeptin was significantly higher in patients with CAP (median 0.88 ng/mL) vs. healthy children (0.33 ng/mL; p < 0.01). ROC analysis showed a high AUC value (0.87) and the cut-off point for plasma copeptin level was 0.44 ng/mL, with a high sensitivity (89 %) and specificity (73 %) in recognizing pneumonia. Patients with higher copeptin concentrations were at higher risk of hyponatremia (OR 2.43). Yet there was only a weak reverse correlation between the sodium and the copeptin concentrations (Spearmann's rank coefficient = -0.19). The levels of copeptin were higher in hyponatremic patients (0.83 ng/mL) vs. normonatremic patients (0.69 ng/mL; p = 0.02). Copeptin elevation did not reflect the CAP severity measured with traditionally used methods. In conclusion, copeptin elevation is a promising marker of pneumonia, but it reflects neither the disease severity nor sodium concentration.
copeptin 与肺炎的严重程度及其并发症相关。本研究旨在评估 copeptin 测量在社区获得性肺炎（CAP）患儿中的有用性及其与疾病严重程度和钠平衡的关系。该研究纳入了 311 名患者（227 名肺炎患者和 84 名健康对照组），年龄 8 天至 18 岁。临床发现和炎症标志物用于预测疾病严重程度。我们发现，CAP 患者的 copeptin 水平明显高于健康儿童（中位数 0.88ng/mL 比 0.33ng/mL；p<0.01）。ROC 分析显示高 AUC 值（0.87），血浆 copeptin 水平的截断值为 0.44ng/mL，对肺炎的识别具有高灵敏度（89%）和特异性（73%）。 copeptin 浓度较高的患者发生低钠血症的风险更高（OR 2.43）。然而，钠和 copeptin 浓度之间仅存在微弱的负相关（Spearmann 秩相关系数=-0.19）。低钠血症患者的 copeptin 水平（0.83ng/mL）高于正常钠血症患者（0.69ng/mL；p=0.02）。 copeptin 升高并不能反映传统方法测量的 CAP 严重程度。总之， copeptin 升高是肺炎的有前途的标志物，但它既不能反映疾病的严重程度，也不能反映钠浓度。
