Department of Emergency and Internal Medicine, Skånes University Hospital, Malmö, Sweden.
Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.
Scand J Clin Lab Invest. 2021 Nov;81(7):593-597. doi: 10.1080/00365513.2021.1980223. Epub 2021 Sep 23.
Increased levels of plasma calprotectin are reported in patients with infectious diseases. However, the clinical usefulness of calprotectin as a biomarker to identify patients with infectious diseases in the emergency department (ED) setting has not been investigated. To study the ability of calprotectin to discriminate patients with acute infectious diseases and dyspnea from patients with other causes of acute dyspnea in the ED setting. Patients aged ≥18 years seeking ED during daytime on weekdays between March 2013 and July 2018, with acute dyspnea, were included. Participants ( = 1287) were triaged according to Medical Emergency Triage and Treatment System-Adult score (METTS-A) or Rapid Emergency Triage and Treatment System (RETTS), and blood samples were collected. The association between calprotectin and other markers of infectious diseases, i.e. biomarkers (CRP, leucocytes) and body temperature, was studied. The predictive value of calprotectin for the outcome of acute infection was evaluated with receiver operating characteristic (ROC) analysis. Univariate cross-sectional regression showed significant associations between calprotectin and leucocytes, CRP and body temperature. Patients with severe infections including pneumonia ( = 119) had significantly higher concentrations of calprotectin compared to patients with heart failure ( = 162) or chronic obstructive pulmonary disease ( = 183). When tested for the outcome of acute infection ( = 109), the area under the ROC curve (AUROC) was for CRP 0.83 and for calprotectin 0.78. Plasma calprotectin identifies infectious diseases in ED patients with acute dyspnea, and the clinical usefulness of Calprotectin in the ED has to be further studied.
有报道称，感染性疾病患者的血浆钙卫蛋白水平升高。然而，钙卫蛋白作为一种生物标志物，用于在急诊科（ED）环境中识别感染性疾病患者的临床实用性尚未得到研究。本研究旨在研究钙卫蛋白在 ED 环境中区分患有急性传染病和呼吸困难的患者与其他急性呼吸困难原因的患者的能力。
纳入 2013 年 3 月至 2018 年 7 月期间工作日白天在 ED 就诊的年龄≥18 岁、有急性呼吸困难的患者。根据医疗急救分类和治疗系统-成人评分（METTS-A）或快速急救分类和治疗系统（RETTS）对患者进行分诊，并采集血样。研究了钙卫蛋白与其他感染性疾病标志物（即生物标志物[CRP、白细胞]和体温）之间的关系。采用受试者工作特征（ROC）分析评估钙卫蛋白对急性感染结局的预测价值。
单变量横断面回归显示，钙卫蛋白与白细胞、CRP 和体温之间存在显著相关性。与心力衰竭患者（ = 162）或慢性阻塞性肺疾病患者（ = 183）相比，患有严重感染（包括肺炎， = 119）的患者钙卫蛋白浓度显著升高。当检测急性感染的结局（ = 109）时，ROC 曲线下面积（AUROC）对于 CRP 为 0.83，对于钙卫蛋白为 0.78。
血浆钙卫蛋白可识别 ED 中急性呼吸困难的感染性疾病，钙卫蛋白在 ED 的临床应用价值尚需进一步研究。
