Medical Sciences Post-Graduate Program, Federal University of Ceará, Fortaleza, Brazil.
Pharmacology Post-Graduate Program, Federal University of Ceará, Fortaleza, Brazil.
Trop Med Int Health. 2022 Aug;27(8):727-734. doi: 10.1111/tmi.13796. Epub 2022 Jul 11.
To investigate the prediction ability of vascular injury biomarkers for haemodialysis requirement in patients with severe leptospirosis.
Prospective study with severe leptospirosis patients hospitalised in Fortaleza, Brazil. Blood samples were collected hospital admission to quantify vascular injury biomarkers: syndecan-1, ICAM-1, VCAM-1, angiopoietin-2 and FGF-23. Two groups were evaluated according to haemodialysis requirement during hospital stay.
Twenty-seven patients were included, with a mean age of 39 ± 18 years. 88.9% were males. 53.8% needed haemodialysis and presented higher levels on hospital admission of syndecan-1 (572 [300-811] vs. 263 [106-421] ng/ml; p = 0.03), angiopoietin-2 (1.52 [0.72-2.72] vs. 0.63 [0.4-1.38] ng/ml; p = 0.01), and FGF-23 (291 [56-2031] vs. 10 [10-806] pg/ml; p = 0.021). Syndecan-1 showed significant correlation with creatinine (r = 0.546; p = 0.05) and total bilirubin levels (r = 0.534; p = 0.013) on hospital admission. Angiopoietin-2 showed significant correlation with creatinine levels (r = 0.513; p = 0.009) on hospital admission and with number of haemodialysis sessions (r = 0.406; p = 0.049). No significant correlation was found with FGF-23. Regarding prognostic performance, combined syndecan-1 and angiopoietin-2 levels had a better ability to predict haemodialysis need in patients with severe leptospirosis (AUC-ROC = 0.744 [95% CI: 0.545-0.943] p = 0.035).
Syndecan-1 and angiopoietin-2 were associated with haemodialysis need in patients with severe leptospirosis and may be useful to improve therapeutic approach and reduce mortality.
探讨血管损伤生物标志物对重症钩端螺旋体病患者血液透析需求的预测能力。
这是一项在巴西福塔莱萨进行的重症钩端螺旋体病患者的前瞻性研究。入院时采集血样，以定量检测血管损伤生物标志物：硫酸乙酰肝素蛋白聚糖-1（syndecan-1）、细胞间黏附分子-1（ICAM-1）、血管细胞黏附分子-1（VCAM-1）、血管生成素-2（angiopoietin-2）和成纤维细胞生长因子-23（FGF-23）。根据患者住院期间是否需要血液透析将其分为两组。
共纳入 27 例患者，平均年龄为 39±18 岁，88.9%为男性。53.8%的患者需要血液透析，入院时其 syndecan-1（572[300-811] vs. 263[106-421]ng/ml；p=0.03）、angiopoietin-2（1.52[0.72-2.72] vs. 0.63[0.4-1.38]ng/ml；p=0.01）和 FGF-23（291[56-2031] vs. 10[10-806]pg/ml；p=0.021）水平显著更高。入院时 syndecan-1 与肌酐（r=0.546；p=0.05）和总胆红素水平（r=0.534；p=0.013）呈显著相关。入院时，angiopoietin-2 与肌酐水平（r=0.513；p=0.009）和血液透析次数（r=0.406；p=0.049）呈显著相关。FGF-23 与这些指标均无显著相关性。就预后表现而言，联合检测 syndecan-1 和 angiopoietin-2 水平对预测重症钩端螺旋体病患者的血液透析需求具有更好的能力（AUC-ROC=0.744[95%CI：0.545-0.943]，p=0.035）。
syndecan-1 和 angiopoietin-2 与重症钩端螺旋体病患者的血液透析需求相关，可能有助于改善治疗方法并降低死亡率。
