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五聚体蛋白3表达在脓毒症心肌病中的诊断效用:一项前瞻性观察性研究的结果

Diagnostic Utility of Pentraxin 3 Expression in Septic Cardiomyopathy: Findings from a Prospective Observational Study.

作者信息

Cui Na, Lv Xiao-Wei, Shao Teng-Hao, Yu Zhan-Biao, Chen Zhi, Sun Tao, Li Tie-Min, Zhang Jin-Wen, Hu Zhen-Jie

机构信息

Department of Critical Care Medicine, The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, 050010, People's Republic of China.

Department of Critical Care Medicine, Affiliated Hospital of Hebei University, Baoding, 071000, People's Republic of China.

出版信息

J Inflamm Res. 2025 May 7;18:6025-6035. doi: 10.2147/JIR.S517566. eCollection 2025.

Abstract

OBJECTIVE

The aim of this study is to investigate the expression levels of Pentraxin 3, PTX3 in patients with septic cardiomyopathy, SCM and evaluate its diagnostic potential for predicting SCM.

METHODS

A prospective observational study was conducted involving 122 patients diagnosed with septic shock between February 2023 and August 2024. Demographic and clinical data, along with plasma PTX3 concentrations were recorded. Participants were categorized into two groups based on the presence of SCM. PTX3 concentrations and their dynamic changes were compared between the groups. The correlations between PTX3 concentrations and other clinical indicators were analyzed, and the influencing factors associated with SCM development were assessed. The predictive performance of PTX3 for SCM was evaluated using receiver operating characteristic, ROC curves.

RESULTS

SCM was identified in 24.6% of the participants. Plasma PTX3 concentrations at admission and on day 3 were significantly higher in the SCM group compared to the non-SCM group, < 0.001. However, no significant differences were observed on day 7, > 0.05. PTX3 concentrations decreased over time in both groups. Plasma PTX3 concentrations were correlated with procalcitonin, lactate, myoglobin, troponin I, the elevated levels of troponin I on day 2 compared to admission, Sequential Organ Failure Assessment score, Acute Physiology and Chronic Health Evaluation II score, and intensive care unit length of stay. Elevated plasma PTX3 concentrations were identified as an independent risk factor for SCM development. The area under the ROC curve for PTX3 in predicting SCM was 0.784, < 0.001, with a cutoff value of 20.82 ng/mL, sensitivity of 0.767, and specificity of 0.707.

CONCLUSION

Plasma PTX3 concentrations are markedly elevated in patients with SCM, indicating that PTX3 may serve as a reliable biomarker for the early diagnosis of SCM.

摘要

目的

本研究旨在调查脓毒症性心肌病(SCM)患者中五聚体3(PTX3)的表达水平,并评估其对SCM的诊断预测潜力。

方法

进行了一项前瞻性观察性研究,纳入了2023年2月至2024年8月期间诊断为感染性休克的122例患者。记录人口统计学和临床数据以及血浆PTX3浓度。根据是否存在SCM将参与者分为两组。比较两组之间PTX3浓度及其动态变化。分析PTX3浓度与其他临床指标之间的相关性,并评估与SCM发生相关的影响因素。使用受试者工作特征(ROC)曲线评估PTX3对SCM的预测性能。

结果

24.6%的参与者被诊断为SCM。SCM组入院时和第3天的血浆PTX3浓度显著高于非SCM组,P<0.001。然而,在第7天未观察到显著差异,P>0.05。两组中PTX3浓度均随时间下降。血浆PTX3浓度与降钙素原、乳酸、肌红蛋白、肌钙蛋白I、与入院时相比第2天肌钙蛋白I水平升高、序贯器官衰竭评估评分、急性生理与慢性健康状况评估II评分以及重症监护病房住院时间相关。血浆PTX3浓度升高被确定为SCM发生的独立危险因素。PTX3预测SCM的ROC曲线下面积为0.784,P<0.001,临界值为20.82 ng/mL,敏感性为0.767,特异性为0.707。

结论

SCM患者血浆PTX3浓度显著升高,表明PTX3可能是SCM早期诊断的可靠生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8b0/12067461/8c7b4531e493/JIR-18-6025-g0001.jpg

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