血清淀粉样蛋白 P 成分 3 作为脓毒症严重程度的标志物和死亡率结局的预测因子：系统评价和荟萃分析。

Pentraxin-3 as a marker of sepsis severity and predictor of mortality outcomes: A systematic review and meta-analysis.

机构信息

Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, SAR, China.

Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China.

出版信息

J Infect. 2018 Jan;76(1):1-10. doi: 10.1016/j.jinf.2017.10.016. Epub 2017 Nov 23.

DOI:10.1016/j.jinf.2017.10.016

PMID:29174966

Abstract

OBJECTIVES

Pentraxin-3 (PTX-3) is a multi-functional pattern recognition molecule produced by various cell types of peripheral tissues in different infections. It is raised in sepsis, but its values in predicting disease severity or mortality outcomes have been controversial. Therefore, we conducted a systematic review and meta-analysis of these associations.

METHODS

PubMed and Embase were searched until July 18, 2017 for studies that evaluated the relationship between PTX-3 levels and disease severity or mortality in sepsis.

RESULTS

A total of 23 and 10 entries were retrieved from both databases, respectively, of which 16 studies were included in the final meta-analysis. A total of 3001 patients (56% male, mean age 63 ± 15 years; mean follow-up duration of 207 days) were analysed. PTX-3 was significantly higher in patients with more severe sepsis compared to those with less severe sepsis (standard mean difference = 18.5 ng/mL, standard error: 4.5 ng/mL, P < 0.0001) and higher in non-survivors compared to survivors (standard mean difference = 40.3 ng/mL, standard error: 6.8 ng/mL, P < 0.0001). Elevated PTX-3 levels significantly increased the risk of all-cause mortality (hazard ratio: 1.91, 95% CI: 1.53 to 2.46, P < 0.0001).

CONCLUSIONS

PTX-3 significantly predicts disease severity and mortality in sepsis.

摘要

目的

血清正五聚蛋白 3（PTX-3）是一种多功能模式识别分子，由外周组织的各种细胞类型在不同感染中产生。它在脓毒症中升高，但预测疾病严重程度或死亡率的价值一直存在争议。因此，我们对这些相关性进行了系统评价和荟萃分析。

方法

检索 PubMed 和 Embase，直到 2017 年 7 月 18 日，评估 PTX-3 水平与脓毒症严重程度或死亡率之间关系的研究。

结果

从这两个数据库中分别检索到 23 项和 10 项，其中 16 项研究纳入最终荟萃分析。共分析了 3001 例患者（56%为男性，平均年龄 63±15 岁；平均随访时间 207 天）。与病情较轻的患者相比，病情较重的患者 PTX-3 显著升高（标准均数差=18.5ng/mL，标准误差：4.5ng/mL，P<0.0001），与存活者相比，非存活者 PTX-3 显著升高（标准均数差=40.3ng/mL，标准误差：6.8ng/mL，P<0.0001）。PTX-3 升高显著增加了全因死亡率的风险（危险比：1.91，95%置信区间：1.53 至 2.46，P<0.0001）。