五聚体蛋白3血清水平和血管紧张素转换酶多态性对COVID-19患者肺部浸润和死亡率的影响
The Impact of Pentraxin 3 Serum Levels and Angiotensin-Converting Enzyme Polymorphism on Pulmonary Infiltrates and Mortality in COVID-19 Patients.
作者信息
Krivdić Dupan Zdravka, Periša Vlatka, Suver Stević Mirjana, Mihalj Martina, Tolušić Levak Maja, Guljaš Silva, Salha Tamer, Loinjak Domagoj, Kos Martina, Šapina Matej, Canjko Ivana, Šambić Penc Mirela, Štefančić Marin, Nešković Nenad
机构信息
Department of Radiology, Osijek University Hospital, 31000 Osijek, Croatia.
Medical Faculty Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia.
出版信息
Biomedicines. 2024 Jul 20;12(7):1618. doi: 10.3390/biomedicines12071618.
OBJECTIVES
The aim of this study was to examine the impact of the pentraxin 3 (PTX3) serum level and angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism on the severity of radiographic pulmonary infiltrates and the clinical outcomes of COVID-19.
METHODS
The severity of COVID-19 pulmonary infiltrates was evaluated within a week of admission by analyzing chest X-rays (CXR) using the modified Brixia (MBrixa) scoring system. The insertion (I)/deletion (D) polymorphism of the gene and the serum levels of PTX3 were determined for all patients included in the study.
RESULTS
This study included 80 patients. Using a cut-off serum level of PTX3 ≥ 2.765 ng/mL, the ROC analysis (AUC 0.871, 95% CI 0.787-0.954, < 0.001) showed a sensitivity of 85.7% and specificity of 78.8% in predicting severe MBrixa scores. Compared to I/I polymorphism, D/D polymorphism significantly increased the risk of severe CXR infiltrates, OR 7.7 (95% CI: 1.9-30.1), and = 0.002. Significant independent predictors of severe CXR infiltrates include hypertension (OR 7.71), PTX3 (OR 1.20), and D/D polymorphism (OR 18.72). Hypertension (OR 6.91), PTX3 (OR 1.47), and ACE I/I polymorphism (OR 0.09) are significant predictors of poor outcomes.
CONCLUSION
PTX3 and D/D polymorphism are significant predictors of the severity of COVID-19 pneumonia. PTX3 is a significant predictor of death.
目的
本研究旨在探讨五聚体3（PTX3）血清水平和血管紧张素转换酶（ACE）基因插入/缺失（I/D）多态性对COVID-19患者胸部X线浸润严重程度及临床结局的影响。
方法
采用改良的布里夏（MBrixa）评分系统，通过分析入院一周内的胸部X线片（CXR）来评估COVID-19肺部浸润的严重程度。测定了本研究所有患者的ACE基因插入（I）/缺失（D）多态性及PTX3血清水平。
结果
本研究纳入80例患者。以PTX3血清水平≥2.765 ng/mL为临界值，ROC分析（AUC 0.871，95%CI 0.787 - 0.954，P<0.001）显示，预测严重MBrixa评分时的敏感性为85.7%，特异性为78.8%。与ACE I/I多态性相比，D/D多态性显著增加了严重CXR浸润的风险，OR为7.7（95%CI：1.9 - 30.1），P = 0.002。严重CXR浸润的显著独立预测因素包括高血压（OR 7.71）、PTX3（OR 1.20）和ACE D/D多态性（OR 18.72）。高血压（OR 6.91）、PTX3（OR 1.47）和ACE I/I多态性（OR 0.09）是不良结局的显著预测因素。
结论
PTX3和ACE D/D多态性是COVID-19肺炎严重程度的显著预测因素。PTX3是死亡的显著预测因素。
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