脂蛋白(a):2019冠状病毒病患者入住重症监护病房的新预测指标
Lipoprotein(a): A New Intensive Care Unit Admission Predictor in Coronavirus Disease 2019 Patients.
作者信息
Küçük Uğur, Kırılmaz Bahadır, Şener Alper, Alkan Sevil, Vurucu Servan, Akşit Ercan
机构信息
Department of Cardiology, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale, Turkey.
Department of Infectious Diseases and Clinical Microbiology, İzmir Katip Çelebi University Faculty of Medicine, İzmir, Turkey.
出版信息
Thorac Res Pract. 2023 Jul;24(4):214-219. doi: 10.5152/ThoracResPract.2023.22065.
OBJECTIVE
Endothelium-related events in patients with coronavirus disease 2019 are linked to a poor prognosis. Lipoprotein(a) plays a role in vascular endothelial cell dysfunction. This research aims to investigate whether baseline serum lipoprotein(a) levels could be a predictor for intensive care unit admission and related clinical parameters in coronavirus disease 2019 patients.
MATERIAL AND METHODS
The research covers 126 patients who were hospitalized in intensive care unit or the non-intensive care unit in our hospital. This prospective cohort study was conducted from January 2021 to June 2021. The patients who were positive for severe acute respiratory syndrome coronavirus 2 according to real-time polymerase chain reaction test results were included in the study. Two groups were created according to the status of intensive care unit admission. Lipoprotein(a) was studied from blood samples taken at the time of hospital admission.
RESULTS
According to the results of the first clinical evaluation, 46 patients were admitted to the intensive care unit and 80 patients were admitted to non-intensive care unit in the hospital. Patients with intensive care unit admission had significantly higher serum lipoprotein(a) levels than patients without intensive care unit admission (40.9 ng/mL and 17.4 ng/mL, P < .001, respectively). The regres- sion analysis revealed that serum lipoprotein(a) levels were independently related to intensive care unit admission (odds ratio 1.242, 95% CI 1.109-1.391, P < .001). In receiver operating characteristic curve analysis, lipoprotein(a) level ≥31.42 ng/mL had 82.6% sensitivity and 72.5% specificity in predicting intensive care unit admission. The risk of intensive care unit admission was seen to be 12.522-fold higher in cases with lipoprotein(a) level ≥31.42.
CONCLUSION
Lipoprotein(a) could be used as a useful biomarker for the triage of coronavirus disease 2019 patients. Baseline serum lipoprotein(a) levels may serve as a useful prognostic biomarker in patients hospitalized for coronavirus disease 2019.
目的
2019冠状病毒病患者中与内皮相关的事件与预后不良有关。脂蛋白(a)在血管内皮细胞功能障碍中起作用。本研究旨在调查基线血清脂蛋白(a)水平是否可作为2019冠状病毒病患者入住重症监护病房及相关临床参数的预测指标。
材料与方法
本研究涵盖了在我院重症监护病房或非重症监护病房住院的126例患者。这项前瞻性队列研究于2021年1月至2021年6月进行。根据实时聚合酶链反应检测结果,严重急性呼吸综合征冠状病毒2呈阳性的患者被纳入研究。根据入住重症监护病房的情况分为两组。在入院时采集的血样中研究脂蛋白(a)。
结果
根据首次临床评估结果,46例患者入住我院重症监护病房,80例患者入住非重症监护病房。入住重症监护病房的患者血清脂蛋白(a)水平显著高于未入住重症监护病房的患者(分别为40.9 ng/mL和17.4 ng/mL,P <.001)。回归分析显示,血清脂蛋白(a)水平与入住重症监护病房独立相关(比值比1.242,95%CI 1.109 - 1.391,P <.001)。在受试者工作特征曲线分析中,脂蛋白(a)水平≥31.42 ng/mL在预测入住重症监护病房方面具有82.6%的敏感性和72.5%的特异性。脂蛋白(a)水平≥31.42的病例入住重症监护病房的风险高出12.522倍。
结论
脂蛋白(a)可作为2019冠状病毒病患者分诊的有用生物标志物。基线血清脂蛋白(a)水平可能是2019冠状病毒病住院患者有用的预后生物标志物。
相似文献
Front Endocrinol (Lausanne). 2021
Intensive Care Med. 2001-1
本文引用的文献
Semin Thromb Hemost. 2023-2
Atherosclerosis. 2022-1
Front Med (Lausanne). 2021-1-20
Nat Rev Rheumatol. 2020-7-30
Curr Atheroscler Rep. 2020-7-25
J Thromb Thrombolysis. 2020-10