生物标志物对卒中相关性肺炎早期诊断的预测价值。
Biomarkers predictive value for early diagnosis of Stroke-Associated Pneumonia.
机构信息
Stroke Research Program, Institute of Biomedicine of Seville, IBiS/Hospital Universitario Virgen del Rocío/CSIC, University of Seville, Seville, Spain.
Neurovascular Research Laboratory. Vall d'Hebron Institute of Research (VHIR), Universitat Autónoma de Barcelona, Barcelona, Spain.
出版信息
Ann Clin Transl Neurol. 2019 Sep;6(9):1882-1887. doi: 10.1002/acn3.50849. Epub 2019 Jul 31.
To confirm the diagnostic accuracy of candidate biomarkers in stroke-associated pneumonia (SAP), we prospectively enrolled ischemic stroke patients with NIHSS ≥ 10 on admission from March-2016 to August-2017. Blood samples were collected at baseline, 24 and 48 h after stroke onset. Biomarkers (MR-proADM, suPAR, SAA) were determined by immunoassays. Regarding biomarkers, MR-proADM at 24 h (P = 0.04) and both suPAR and SAA at 48 h (P = 0.036 and P = 0.057) were associated with pneumonia. The combination of SAA > 25.15 mg/dL and suPAR> 3.14 ng/mL at 48 h had 80% sensitivity and 95.8% specificity when both biomarkers were above the cut-off. The evaluated biomarkers represent promising tools to be evaluated in future large, prospective studies on SAP. An accurate SAP diagnosis by thorax CT might help to reduce variability in such studies.
为了确认候选生物标志物在卒中相关性肺炎（SAP）中的诊断准确性，我们前瞻性地招募了 2016 年 3 月至 2017 年 8 月入院时 NIHSS≥10 的缺血性脑卒中患者。在基线、卒中发作后 24 和 48 小时采集血样。采用免疫测定法测定生物标志物（MR-proADM、suPAR、SAA）。关于生物标志物，24 小时时的 MR-proADM（P=0.04）和 48 小时时的 suPAR 和 SAA（P=0.036 和 P=0.057）与肺炎相关。48 小时时 SAA>25.15mg/dL 和 suPAR>3.14ng/mL 的联合检测，当两个生物标志物均超过临界值时，其敏感性为 80%，特异性为 95.8%。评估的生物标志物代表了未来 SAP 大型前瞻性研究中有待评估的有前途的工具。胸部 CT 对 SAP 的准确诊断可能有助于减少此类研究中的变异性。
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