Center for Infectious Diseases, Second Affiliated Hospital of Air Force Medical University, 569 Xinsi Rd, Baqiao District, Xi'an, 710038, Shaanxi, China.
BMC Infect Dis. 2021 May 17;21(1):445. doi: 10.1186/s12879-021-06145-0.
Hemorrhagic fever with renal syndrome (HFRS) caused by Hantaan virus is characterized by systemic immunopathological injury. Pentraxin-3 is an acute-phase reactant involved in the processes of inflammation and infection. This study aimed to investigate the levels of plasma pentraxin-3 and evaluate its predictive value on disease severity and mortality risk in patients with HFRS.
This was a prospective real-world observational study. The concentrations of plasma pentraxin-3 were measured by enzyme linked immunosorbent assay (ELISA) in 105 HFRS patients and 27 healthy controls. We analyzed the clinical relevance between pentraxin-3 and clinical subtyping, hospital stay and conventional laboratory parameters of HFRS patients. Considering the prognosis (death) as the primary endpoint, the levels of pentraxin-3 between survivors and non-survivors were compared, and its association with mortality was assessed by Kaplan-Meier survival analysis. The predictive potency of pentraxin-3 for mortality risk in HFRS patients was evaluated by receiver operating characteristic (ROC) curve analysis.
The levels of pentraxin-3 during the acute phase were increased with the aggravation of the disease, and showed the highest expression in critical-type patients (P < 0.05). Pentraxin-3 demonstrated significant correlations with conventional laboratory parameters (WBC, PLT, AST, ALB, APTT, Fib) and the length of hospital stay. Compared with the survivors, non-survivors showed higher levels of pentraxin-3 and worse expressions of conventional laboratory parameters during the acute phase. The Kaplan-Meier survival curves showed that high levels of pentraxin-3 during the acute phase were significantly associated with the death in HFRS patients. Pentraxin-3 demonstrated significant predictive value for the mortality risk of HFRS patients, with the area under ROC curve (AUC) of 0.753 (95%CI: 0.593 ~ 0.914, P = 0.003).
The detection of plasma pentraxin-3 might be beneficial to the evaluation of disease severity and to the prediction of mortality risk in HFRS patients.
汉坦病毒引起的肾综合征出血热（HFRS）以全身免疫病理损伤为特征。五聚素 3 是一种参与炎症和感染过程的急性期反应物。本研究旨在探讨血浆五聚素 3 的水平，并评估其对 HFRS 患者疾病严重程度和死亡风险的预测价值。
这是一项前瞻性真实世界观察性研究。通过酶联免疫吸附试验（ELISA）测量 105 例 HFRS 患者和 27 例健康对照者的血浆五聚素 3 浓度。我们分析了五聚素 3 与临床分型、住院时间和 HFRS 患者常规实验室参数之间的临床相关性。考虑到预后（死亡）作为主要终点，比较了幸存者和非幸存者之间的五聚素 3 水平，并通过 Kaplan-Meier 生存分析评估其与死亡率的关系。通过受试者工作特征（ROC）曲线分析评估五聚素 3 对 HFRS 患者死亡风险的预测能力。
急性期五聚素 3 水平随病情加重而升高，危重型患者表达最高（P<0.05）。五聚素 3 与常规实验室参数（WBC、PLT、AST、ALB、APTT、Fib）和住院时间均有显著相关性。与幸存者相比，非幸存者在急性期表现出更高的五聚素 3 水平和更差的常规实验室参数表达。Kaplan-Meier 生存曲线显示，急性期高五聚素 3 水平与 HFRS 患者死亡显著相关。五聚素 3 对 HFRS 患者的死亡风险具有显著的预测价值，ROC 曲线下面积（AUC）为 0.753（95%CI：0.593~0.914，P=0.003）。
检测血浆五聚素 3 可能有助于评估 HFRS 患者的疾病严重程度，并预测其死亡风险。
