|本期目录/Table of Contents|

[1]张黎黎,杨 敏,石娅妮,等.MR-proADM作为社区获得性肺炎预后生物标志物的临床分析[J].中华肺部疾病杂志,2023,(05):706-708.[doi:10.3877/cma.j.issn.1674-6902.2023.05.027]
点击复制

MR-proADM作为社区获得性肺炎预后生物标志物的临床分析(PDF)

《中华肺部疾病杂志》[ISSN:1006-6977/CN:61-1281/TN]

卷:
期数:
2023年05期
页码:
706-708
栏目:
临床研究
出版日期:
2023-10-20

文章信息/Info

Title:
-
作者:
张黎黎; 杨 敏; 石娅妮; 谭红霞
408000 重庆,重庆大学附属涪陵医院全科医学科
Author(s):
-
关键词:
肾上腺髓质素前体;  社区获得性肺炎;  疾病严重程度;  预后
Keywords:
-
分类号:
R563
DOI:
10.3877/cma.j.issn.1674-6902.2023.05.027
摘要:
目的 分析肾上腺髓质素前体中肽段(mid-regional proAdrenomedullin, MR-proADM)作为社区获得性肺炎(CAP)预后生物标志物的潜在效用。方法 2018年10月至2020年4月,我院收治的CAP患者63例作为对象,纳入58例健康者作为对照组。使用时间分辨荧光免疫分析法测定血浆MR-proADM含量。通过受试者工作特征(ROC)曲线来评估其识别能力。采用Spearman秩相关检验和Logistic回归检验评估MR-proADM水平与疾病严重程度和预后之间的相关性。结果 CAP患者血浆MR-proADM水平为0.92(0.48,1.67)nmol/L,高于对照组[0.35(0.16,0.63)nmol/L](P<0.001)。血浆MR-proADM对CAP有识别价值,ROC曲线下面积为0.744(95%CI:0.674～0.813)。血浆MR-proADM水平与肺炎严重程度指数(r=0.379,P<0.001)、CURB-65(r=0.230,P=0.007)、住院时间(r=0.546,P<0.001)之间存在正相关。基于多变量Logistic回归分析,血浆MR-proADM浓度对院内死亡、入住ICU和住院时间>10 d具有预测能力(P<0.05)。结论 MR-proADM可以用于临床初步筛查CAP的一个潜在的预后生物标志物。
Abstract:
-

参考文献/References:

1 申春梅, 冷蓓铮, 刘亚隽, 等. 成人非典型社区获得性肺炎患者病原体感染情况分析[J]. 检验医学, 2020, 35(1): 29-32.
2 刘 熙, 李 琦. 我国成人社区获得性肺炎诊疗现状及思考[J/CD]. 中华肺部疾病杂志(电子版), 2021, 14(3): 387-389.
3 Kurt E, Ak R, Eke Kurt SZ, et al. Prognostic utility of CURB-65 and E-CURB-65 scoring systems in healthcare associated pneumonia patients: Short-and long-term mortality[J]. Niger J Clin Pract, 2021, 24(11): 1706-1711.
4 孙 振, 夏 丽, 余红梅. PSI评分和CURB-65评分对不同年龄分段老年社区获得性肺炎预后评估价值的研究[J]. 中华全科医学, 2020, 18(3): 392-395, 407.
5 Baumann P, Fuchs A, Gotta V, et al. The kinetic profiles of copeptin and mid regional proadrenomedullin(MR-MR-proADM)in pediatric lower respiratory tract infections[J]. PLoS One, 2022, 17(3): e0264305-e0264317.
6 Kitamura K, Sakata J, Kangawa K, et al. Cloning and characterization of cDNA encoding a precursor for human adrenomedullin[J]. Biochem Biophys Res Commun, 1993, 194(2): 720-725.
7 Iring A, Jin YJ, Albarrán-Juárez J, et al. Shear stress-induced endothelial adrenomedullin signaling regulates vascular tone and blood pressure[J]. J Clin Invest, 2019, 129(7): 2775-2791.
8 Samson WK. Proadrenomedullin-derived peptides[J]. Front Neuroendocrinol, 1998, 19(2): 100-127.
9 Piccioni A, Saviano A, Cicchinelli S, et al. Proadrenomedullin in sepsis and septic shock: A role in the emergency department[J]. Medicina(Kaunas), 2021, 57(9): 920-926.
10 Fahmey SS, Mostafa H, Elhafeez NA, et al. Diagnostic and prognostic value of proadrenomedullin in neonatal sepsis[J]. Korean J Pediatr, 2018, 61(5): 156-159.
11 Mandell LA, Wunderink RG, Anzueto A, et al. Infectious diseases society of America/American Thoracic Society Consensus Guidelines on the management of community-acquired pneumonia in adults[J]. Clin Infect Dis, 2007, 44(Suppl 2): S27-S72.
12 Aliberti S, Cruz CSD, Amati F, et al. Community-acquired pneumonia[J]. Lancet, 2021, 398(10303): 906-919.
13 Metlay JP, Waterer GW, Long AC, et al. Diagnosis and treatment of adults with community-acquired pneumonia. An official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America[J]. Am J Respir Crit Care Med, 2019, 200(7): e45-e67.
14 Torres A, Cillóniz C, Ferrer M, et al. Bacteraemia and antibiotic-resistant pathogens in community acquired pneumonia: risk and prognosis[J]. Eur Respir J, 2015, 45(5): 1353-1363.
15 Charles CJ, Lainchbury JG, Nicholls MG, et al. Adrenomedullin and the renin-angiotensin-aldosterone system[J]. Regul Pept, 2003, 112(1-3): 41-49.
16 Ishiyama H, Tanaka T, Saito S, et al. Plasma mid-regional pro-adrenomedullin: A biomarker of the ischemic penumbra in hyperacute stroke[J]. Brain Pathol, 2023, 33(2): e13110-e13121.
17 Meyer Sauteur PM, Berger C. Proadrenomedullin in mycoplasma pneumoniae community-acquired pneumonia in Children[J]. Clin Infect Dis, 2021, 73(7): e1769-e1771.
18 王 娜, 李俊玉, 商 娜. 肾上腺髓质中段肽联合危重症评分在脓毒症患者预后评价中的作用[J]. 中国急救医学, 2022, 42(3): 204-208.
19 Ferrero H, Larrayoz IM, Gil-Bea FJ, et al. Adrenomedullin, a novel target for neurodegenerative diseases[J]. Mol Neurobiol, 2018, 55(12): 8799-8814.
20 van Lier D, Kox M, Pickkers P. Promotion of vascular integrity in sepsis through modulation of bioactive adrenomedullin and dipeptidyl peptidase 3[J]. J Intern Med, 2021, 289(6): 792-806.
21 Osman M, Manosuthi W, Kaewkungwal J, et al. Etiology, clinical course, and outcomes of pneumonia in the elderly: a retrospective and prospective cohort study in Thailand[J]. Am J Trop Med Hyg, 2021, 104(6): 2009-2016.
22 张春玲, 杨远见, 刘 畅, 等. 血清降钙素原、肝素结合蛋白、白细胞介素-6联合序贯器官衰竭评分对重症肺炎患者预后评估的意义[J]. 实用医学杂志, 2022, 38(2): 168-172.
23 郭沫然, 张志华, 张秀珑. 肾上腺髓质素与血小板相关参数对社区获得性肺炎的诊断价值[J]. 中国呼吸与危重监护杂志, 2019, 18(6): 577-580.
24 pinarová M, pinar J, pinarová L, et al. Relation between mid-regional pro-adrenomedullin in patients with chronic heart failure and the dose of diuretics in 2-year follow-up-data from FAR NHL registry[J]. Medicina, 2022, 58(10): 1477-1486.
25 Öner Ö, Deveci F, Telo S, et al. MR-proADM and MR-proANP levels in patients with acute pulmonary embolism[J]. J Med Biochem, 2020, 39(3): 328-335.
26 Horiuchi Y, Wettersten N, Patel MP, et al. Biomarkers enhance discrimination and prognosis of type 2 myocardial infarction[J]. Circulation, 2020, 142(16): 1532-1544.
27 Baldirà J, Ruiz-Rodríguez JC, Wilson DC, et al. Biomarkers and clinical scores to aid the identification of disease severity and intensive care requirement following activation of an in-hospital sepsis code[J]. Ann Intensive Care, 2020, 10(1): 7-17.
28 Liu D, Xie L, Zhao H, et al. Prognostic value of mid-regional pro-adrenomedullin(MR-proADM)in patients with community-acquired pneumonia: a systematic review and meta-analysis[J]. BMC Infect Dis, 2016, 16(1): 232-242.
29 Fialek B, De Roquetaillade C, Pruc M, et al. Systematic review with meta-analysis of mid-regional pro-adrenomedullin(MR-proadm)as a prognostic marker in Covid-19-hospitalized patients[J]. Ann Med, 2023, 55(1): 379-387.
30 Gregoriano C, Koch D, Kutz A, et al. The vasoactive peptide MR-pro-adrenomedullin in COVID-19 patients: an observational study[J]. Clin Chem Lab Med, 2021, 59(5): 995-1004.

备注/Memo

备注/Memo:
基金项目: 重庆市科委联合计划项目(FLKJ2022ABB2105)
通信作者: 谭红霞, Email: 2381787605@qq.com
更新日期/Last Update: 2023-10-20