HDL-c levels predict the presence of pleural effusion and the clinical outcome of community-acquired pneumonia
HDL-c levels predict the presence of pleural effusion and the clinical outcome of community-acquired pneumonia
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DOI：
10.1186/s40064-016-3145-x
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发表时间：
2016-09-06
期刊：
影响因子：
--
通讯作者：
Castro, A.
中科院分区：
文献类型：
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作者：
Saballs, M.;Parra, S.;Castro, A.
目的：为了研究高密度脂蛋白胆固醇（HDL-C）是否可以根据社区获得性肺炎（CAP）或临床并发症（如胸腔积液）的发展的预后预测评分作为严重程度的生物标志物，我们纳入了一项回顾性研究，在2011年10月30日至2012年9月1日期间，107例符合CAP诊断标准的住院患者。结果：基础HDL-c水平与CAP预后评分（PSI和CURB 65）无统计学差异，与CAP预后评分（PSI和CURB 65）无统计学差异。HDL-c水平显著降低也与感染性休克的发生和进入重症监护室有关。HDL-c与急性时相反应物CRP（r =-0.585，P < 0.001）、ESR（r =-0.477，P < 0.001）、白细胞计数（r =-0.254，P < 0.009）呈负相关。胸腔积液患者的HDL-c水平显著降低[ 28.9（15.5）mg/dl vs. 44.6（21.1）mg/dl]; P = 0.007。在多变量分析和使用ROC分析中，HDL-c是胸腔积液存在的良好预测因子[AUC = 0.712（0.591-0.834），P = 0.006]。HDL-c <10 mg/dl诊断CAP患者胸腔积液的敏感性为97.6%，特异性为82.4%。结论：监测CAP患者HDL-c水平可作为判断CAP急性期反应、临床预后和胸腔积液的血清学指标。
Objectives: To investigate if HDL cholesterol (HDL-c) could be a biomarker of the degree of severity according to prognostic prediction scores in community-acquired pneumonia (CAP) or the development of clinical complications such as pleural effusion.Methods: We included in a retrospective study 107 patients admitted to the hospital that fulfilled diagnostic criteria for CAP between the 30th October 2011 and 1st September 2012. HDL-c levels at admission, CAP prognosis scores (PSI and CURB65) and clinical outcomes were recorded for the study.Results: Basal HDL-c levels were not statistically different according to prognostics scores neither PSI nor CURB65. Significantly lower levels of HDL-c were also associated to the development of septic shock and admission to the intensive care unit. HDL-c were inversely correlated with acute phase reactants CRP (r = -0.585, P < 0.001), ESR (r = -0.477, P < 0.001), and leukocytes cell count (r = -0.254, P < 0.009). Patients with pleural effusion showed significant lower levels of HDL-c [ 28.9 (15.5) mg/dl vs. 44.6 (21.1) mg/dl]; P = 0.007. HDL-c is a good predictor of the presence of pleural effusion in multivariate analyses and using ROC analyses [AUC = 0.712 (0.591-0.834), P = 0.006]. HDL-c levels of 10 mg/dl showed a sensitivity of 97.6 % and a specificity of 82.4 % for the presence of pleural effusion.Conclusion: Monitoring HDL-c in CAP is an useful serum marker of acute phase response, clinical outcome and the presence of pleural effusion.