Yang Wanchun, Dong Wei
Department of Emergency, Hami Red Star Hospital, No. 19 Qianjin East Road, Yizhou District, Hami City, 839000, China.
Intensive Care Medical Center, Hami Red Star Hospital, No. 19 Qianjin East Road, Yizhou District, Hami City, 839000, China.
Mediterr J Hematol Infect Dis. 2025 May 1;17(1):e2025029. doi: 10.4084/MJHID.2025.029. eCollection 2025.
Heparin-binding protein (HBP) is a granule protein derived from neutrophils, located in secretory vesicles and neutrophilic granules, also known as cationic antimicrobial protein of 37 kDa (CAP37) or azurocidin. This study evaluates the diagnostic and prognostic value of HBP levels in relation to infection, organ dysfunction, and mortality in adult patients. A systematic review and meta-analysis were conducted by searching PubMed, Web of Science, EMBASE, and the Cochrane Database from their inception through June 2024. Original studies assessing HBP levels' diagnostic and prognostic utility in predicting infection and disease severity in critically ill adult patients were included. The primary outcome was the diagnostic and predictive role of HBP in infection and severity. The Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool was used to evaluate bias risk. A total of 56 studies involving 11,486 patients were included. Pooled analysis showed HBP had a sensitivity of 0.87 (95% CI, 0.82-0.91), specificity of 0.87 (95% CI, 0.79-0.92), and an AUC of 0.93 (95% CI, 0.91-0.95) for infection diagnosis. For prognostic assessment, sensitivity was 0.77 (95% CI, 0.74-0.80), specificity was 0.72 (95% CI, 0.68-0.76), and AUC was 0.81 (95% CI, 0.78-0.85). HBP outperformed procalcitonin (PCT), C-reactive protein (CRP), and white blood cell count (WBC) in diagnosing and predicting critical illness. No publication bias was detected. HBP demonstrates high sensitivity and specificity for diagnosing infections in critically ill adult patients. Additionally, it effectively predicts disease progression, including organ dysfunction and mortality, surpassing traditional biomarkers such as PCT, CRP, and WBC. All that cannot be true for subjects with severe neutropenia.
肝素结合蛋白（HBP）是一种源自中性粒细胞的颗粒蛋白，位于分泌囊泡和嗜中性粒细胞颗粒中，也被称为37 kDa阳离子抗菌蛋白（CAP37）或天青杀素。本研究评估了HBP水平在成年患者感染、器官功能障碍和死亡率方面的诊断和预后价值。通过检索PubMed、Web of Science、EMBASE和Cochrane数据库，从其创建至2024年6月进行了一项系统综述和荟萃分析。纳入了评估HBP水平在预测重症成年患者感染和疾病严重程度方面的诊断和预后效用的原始研究。主要结局是HBP在感染和严重程度方面的诊断和预测作用。使用诊断准确性研究质量评估2（QUADAS - 2）工具来评估偏倚风险。共纳入了56项研究，涉及11486名患者。汇总分析显示，HBP对感染诊断的敏感性为0.87（95%CI，0.82 - 0.91），特异性为0.87（95%CI，0.79 - 0.92），AUC为0.93（95%CI，0.91 - 0.95）。对于预后评估，敏感性为0.77（95%CI，0.74 - 0.80），特异性为0.72（95%CI，0.68 - 0.76），AUC为0.81（95%CI，0.78 - 0.85）。在诊断和预测危重病方面，HBP的表现优于降钙素原（PCT）、C反应蛋白（CRP）和白细胞计数（WBC）。未检测到发表偏倚。HBP在诊断重症成年患者感染方面表现出高敏感性和特异性。此外，它能有效预测疾病进展，包括器官功能障碍和死亡率，优于PCT、CRP和WBC等传统生物标志物。但对于严重中性粒细胞减少的患者并非如此。
