The role of resistin and myeloperoxidase in severe sepsis and septic shock: Results from the ALBIOS trial
The role of resistin and myeloperoxidase in severe sepsis and septic shock: Results from the ALBIOS trial
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DOI：
10.1111/eci.13333
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发表时间：
2020-10-01
影响因子：
5.5
通讯作者：
Montecucco, Fabrizio
中科院分区：
文献类型：
--
作者：
Bonaventura, Aldo;Carbone, Federico;Montecucco, Fabrizio
炎症生物标志物在检测脓毒症患者中是有用的。抵抗素和髓过氧化物酶（MPO）在脓毒症中的预后作用已被研究。材料与方法957名意大利白蛋白结局败血症（ALBIOS）试验的患者在第1、2和7天测量血浆抵抗素和MPO。评估第1、2和7天抵抗素和MPO水平与90天死亡率之间的关系。结果血浆抵抗素和MPO浓度在第1天升高，第7天下降。这两种生物标志物相互之间以及与生理参数呈正相关。第1天较高的抵抗素和MPO水平与新器官衰竭的发生有关。与幸存者相比，90天死亡的患者表现出更高的抵抗素和MPO水平。在第1天，发现只有第4四分位数（Q4）的MPO预测90天死亡，而抵抗素不预测（校正风险比[aHR] 1.55 vs Q1）。在第2天，Q3和Q4的抵抗素预测死亡率增加约40%，Q4的MPO也预测死亡率增加约40%。在第7天，Q4抵抗素能够预测90天死亡率，而MPO的所有四分位数都不能预测。结论：第1天的高MPO水平可预测90天死亡率，但抵抗素水平不高。这些发现可能表明，嗜中性粒细胞的早期过度活化对败血症患者是有害的，或者反映了败血症引起的炎症过程的负担。需要进一步的研究来深化这些方面（ALBIOS ClinicalTrials.gov标识符：NCT00707122）。
Background Inflammatory biomarkers are useful in detecting patients with sepsis. The prognostic role of resistin and myeloperoxidase (MPO) has been investigated in sepsis. Materials and Methods Plasma resistin and MPO were measured on days 1, 2 and 7 in 957 patients enrolled in the Albumin Italian Outcome Sepsis (ALBIOS) trial. The association between resistin and MPO levels on day 1, 2 and 7 and 90-day mortality was assessed. Results Plasma resistin and MPO concentrations were higher at day 1 and decreased until day 7. Both biomarkers were positively correlated with each other and with physiological parameters. Higher levels of resistin and MPO on day 1 were associated with the development of new organ failures. Patients experiencing death at 90 days showed higher levels of resistin and MPO compared with survivors. At day 1, only MPO in the 4th quartile (Q4), but not resistin, was found to predict 90-day death (adjusted hazard ratio [aHR] 1.55 vs Q1). At day 2, resistin in the Q3 and Q4 predicted a > 40% increase in mortality as also did MPO in the Q4. On day 7, Q4 resistin was able to predict 90-day mortality, while all quartiles of MPO were not. Conclusions High levels of MPO, but not of resistin, on day 1 were able to predict 90-day mortality. These findings may either suggest that early hyper-activation of neutrophils is detrimental in patients with sepsis or reflect the burden of the inflammatory process caused by sepsis. Further studies are warranted to deepen these aspects (ALBIOS ClinicalTrials.gov Identifier: NCT00707122).