Department of Infectious Diseases, Skåne University Hospital, Lund, Sweden.
Division of Infection Medicine, Department of Clinical Sciences, Faculty of Medicine, Lund University, BMC B14, SE221 85, Lund, Sweden.
Respir Res. 2021 Jun 8;22(1):174. doi: 10.1186/s12931-021-01764-2.
Ventilator-associated pneumonia (VAP) is difficult to diagnose using clinical criteria and no biomarkers have yet been proved to be sufficiently accurate. The use of the neutrophil-derived Heparin-binding protein (HBP) as a biomarker for pneumonia was investigated in this exploratory case-control study in two intensive care units at a tertiary referral hospital.
Patients with clinical signs of pneumonia were recruited and bronchoalveolar lavage fluid (BALF) or bronchial wash (BW) samples were collected. Mechanically ventilated and lung healthy subjects were recruited as controls. HBP was measured with enzyme-linked immunosorbent assay.
BALF was collected from 14 patients with pneumonia and 14 healthy controls. Median HBP in BALF pneumonia samples was 14,690 ng/ml and controls 16.2 ng/ml (p < 0.0001). BW was collected from 10 pneumonia patients and 10 mechanically ventilated controls. Median HBP in BW pneumonia was 9002 ng/ml and controls 7.6 ng/ml (p < 0.0001).
These data indicate that HBP concentrations is significantly higher in lower airway samples from patients with pneumonia than control subjects and is a potentially useful biomarker for diagnosis of VAP.
使用临床标准诊断呼吸机相关性肺炎（VAP）较为困难，且尚未有任何生物标志物被证实具有足够的准确性。本探索性病例对照研究在一家三级转诊医院的两个重症监护病房中，调查了中性粒细胞衍生的肝素结合蛋白（HBP）作为肺炎生物标志物的应用。
招募有肺炎临床体征的患者，并采集支气管肺泡灌洗液（BALF）或支气管冲洗（BW）样本。将机械通气且肺部健康的受试者作为对照进行招募。使用酶联免疫吸附试验测量 HBP。
从 14 例肺炎患者和 14 例健康对照者中采集了 BALF。肺炎患者 BALF 样本中的 HBP 中位数为 14690ng/ml，对照组为 16.2ng/ml（p<0.0001）。从 10 例肺炎患者和 10 例机械通气对照者中采集了 BW。肺炎患者 BW 中的 HBP 中位数为 9002ng/ml，对照组为 7.6ng/ml（p<0.0001）。
这些数据表明，肺炎患者下呼吸道样本中的 HBP 浓度明显高于对照组，是诊断 VAP 的潜在有用生物标志物。
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