Hamed Sonja, Behnes Michael, Pauly Dominic, Lepiorz Dominic, Barre Max, Becher Tobias, Lang Siegfried, Akin Ibrahim, Borggrefe Martin, Bertsch Thomas, Hoffmann Ursula
First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, Mannheim, 68167, Germany.
Institute of Clinical Chemistry, Laboratory Medicine and Transfusion Medicine, General Hospital Nuremberg, Paracelsus Medical University, Nuremberg, Germany.
BMC Infect Dis. 2017 Aug 9;17(1):554. doi: 10.1186/s12879-017-2606-3.
Pentraxin-3 (PTX-3) is an acute-phase protein involved in inflammatory and infectious processes. This study assesses its diagnostic and prognostic value in patients with sepsis or septic shock in a medical intensive care unit (ICU).
The study includes 213 ICU patients with clinical criteria of sepsis and septic shock. 77 donors served as controls. Plasma levels of PTX-3, procalcitonin (PCT) and interleukin-6 were measured on day 1, 3 and 8.
PTX-3 correlated with higher lactate levels as well as with APACHE II and SOFA scores (p = 0.0001). PTX-3 levels of patients with sepsis or septic shock were consistently significantly higher than in the control group (p ≤ 0.001). Plasma levels were able to discriminate sepsis and septic shock significantly on day 1, 3 and 8 (range of AUC 0.73-0.92, p = 0.0001). Uniform cut-off levels were defined at ≥5 ng/ml for at least sepsis, ≥9 ng/ml for septic shock (p = 0.0001).
PTX-3 reveals diagnostic value for sepsis and septic shock during the first week of intensive care treatment, comparable to interleukin-6 according to latest Sepsis-3 definitions.
NCT01535534 . Registered 14.02.2012.
五聚体蛋白3(PTX-3)是一种参与炎症和感染过程的急性期蛋白。本研究评估其在医学重症监护病房(ICU)中脓毒症或脓毒性休克患者中的诊断和预后价值。
该研究纳入213例符合脓毒症和脓毒性休克临床标准的ICU患者。77名捐赠者作为对照。在第1、3和8天测量PTX-3、降钙素原(PCT)和白细胞介素-6的血浆水平。
PTX-3与较高的乳酸水平以及急性生理与慢性健康状况评分系统II(APACHE II)和序贯器官衰竭评估(SOFA)评分相关(p = 0.0001)。脓毒症或脓毒性休克患者的PTX-3水平始终显著高于对照组(p≤0.001)。血浆水平在第1、3和8天能够显著区分脓毒症和脓毒性休克(曲线下面积范围为0.73 - 0.92,p = 0.0001)。定义统一的临界值水平为至少脓毒症≥5 ng/ml,脓毒性休克≥9 ng/ml(p = 0.0001)。
根据最新的脓毒症3定义,PTX-3在重症监护治疗的第一周对脓毒症和脓毒性休克具有诊断价值,与白细胞介素-6相当。
NCT01535534。于2012年2月14日注册。