Laboratory of Molecular Medicine, Department of Clinical Immunology, Rigshospitalet, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Laboratory of Molecular Medicine, Department of Clinical Immunology, Rigshospitalet, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
J Infect. 2020 Apr;80(4):378-387. doi: 10.1016/j.jinf.2020.01.010. Epub 2020 Jan 23.
To evaluate the complement related pattern recognition molecules (PRMs) PTX3, MBL, CL-11, ficolin-2 and -3, along with the established marker CRP, to predict 28-day mortality and disease severity of sepsis in patients admitted to the intensive care unit (ICU).
In a single-center, prospective, observational study 547 patients were included over a period of 18 months. Blood samples were obtained at admission to the ICU and the following 4 days.
PTX3 baseline levels were significantly higher in non-survivors compared to survivors, whereas MBL and ficolin-2 levels were significantly lower in non-survivors compared to survivors. A PTX3 level above the median was independently associated with 28-day mortality in the adjusted analysis including age, sex, chronic disease and immunosuppression (HR 1.87, 95% CI [1.41-2.48], p < 0.0001), while a MBL level above the median was associated with increased chance of survival (HR 0.75, 95% CI [0.57-0.98], p = 0.034). Ficolin-2 was only borderline significant (HR 0.79, 95% CI [0.60-1.03], p = 0.084). In a ROC analysis PTX3 was superior to CRP in predicting septic shock.
PTX3, MBL and CRP levels were independently associated with 28-day mortality in ICU patients. PTX3 was a better marker of septic shock compared to CRP.
评估补体相关模式识别分子（PRMs）PTX3、MBL、CL-11、ficolin-2 和 -3 以及已建立的标志物 CRP，以预测入住重症监护病房（ICU）的脓毒症患者的 28 天死亡率和疾病严重程度。
在一项单中心、前瞻性、观察性研究中，在 18 个月的时间内纳入了 547 名患者。在入住 ICU 时和接下来的 4 天内采集血液样本。
与幸存者相比，非幸存者的 PTX3 基线水平显着升高，而 MBL 和 ficolin-2 水平显着降低。在包括年龄、性别、慢性疾病和免疫抑制在内的调整分析中，PTX3 水平高于中位数与 28 天死亡率独立相关（HR 1.87，95%CI [1.41-2.48]，p<0.0001），而 MBL 水平高于中位数与生存率增加相关（HR 0.75，95%CI [0.57-0.98]，p=0.034）。ficolin-2 仅具有边缘显着性（HR 0.79，95%CI [0.60-1.03]，p=0.084）。在 ROC 分析中，PTX3 在预测脓毒性休克方面优于 CRP。
PTX3、MBL 和 CRP 水平与 ICU 患者的 28 天死亡率独立相关。与 CRP 相比，PTX3 是脓毒性休克的更好标志物。
