Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing, China.
Infection. 2021 Oct;49(5):877-888. doi: 10.1007/s15010-021-01585-x. Epub 2021 Mar 10.
Early diagnosis and prognosis of patients with community-acquired pneumonia (CAP) are still difficult clinical challenges. This study aimed to investigate the role of lysophosphatidylethanolamine acyltransferase (LPEAT) in CAP and to evaluate the effectiveness of this enzyme as an indicator of disease severity and risk of death in CAP.
This retrospective, multi-center study was conducted in 2017. A total of 267 patients with CAP were included. Of these 267 patients, 175 patients had non-severe CAP (non-SCAP) and 92 patients had severe CAP (SCAP). In addition, we recruited 15 healthy volunteers and 42 hospitalized disease controls in our study. The demographic and clinical characteristics were recorded for all participants. Admission levels of LPEAT were determined by quantitative enzyme-linked immunosorbent assay.
Admission levels of LPEAT in patients with SCAP were significantly higher, particularly in non-survivors and were not affected by the causative etiology. Furthermore, when the patients were stratified according to PSI and CURB-65 scores, the patients with high severity scores had higher LPEAT levels upon admission than patients with low severity scores. LPEAT also performed well in predicting SCAP in patients with CAP. Moreover, LPEAT could predict the 30-day mortality rate of patients with CAP, and combining LPEAT with the clinical severity score further improved the accuracy of mortality prediction.
Elevated LPEAT levels can reliably predict the severity of illness in patients with CAP at the time of admission. Adding LPEAT to clinical scoring methods could improve prognostic accuracy. Trial registration ClinicalTrials.gov, NCT03093220. Registered on March 28th, 2017.
社区获得性肺炎(CAP)患者的早期诊断和预后仍然是具有挑战性的临床难题。本研究旨在探讨溶血磷脂酰乙醇胺酰基转移酶(LPEAT)在 CAP 中的作用,并评估该酶作为 CAP 疾病严重程度和死亡风险的指标的有效性。
本回顾性、多中心研究于 2017 年进行。共纳入 267 例 CAP 患者。其中 175 例为非重症 CAP(非 SCAP),92 例为重症 CAP(SCAP)。此外,我们还招募了 15 名健康志愿者和 42 名住院疾病对照者。记录所有参与者的人口统计学和临床特征。采用定量酶联免疫吸附试验测定入院时 LPEAT 的水平。
SCAP 患者入院时 LPEAT 水平显著升高,尤其是在非幸存者中,且不受病因学的影响。此外,当根据 PSI 和 CURB-65 评分对患者进行分层时,高严重程度评分的患者入院时 LPEAT 水平高于低严重程度评分的患者。LPEAT 在预测 CAP 中的 SCAP 方面也表现良好。此外,LPEAT 可预测 CAP 患者的 30 天死亡率,将 LPEAT 与临床严重程度评分相结合可进一步提高死亡率预测的准确性。
入院时升高的 LPEAT 水平可可靠预测 CAP 患者的疾病严重程度。将 LPEAT 添加到临床评分方法中可以提高预后准确性。
ClinicalTrials.gov,NCT03093220。于 2017 年 3 月 28 日注册。