OBJECTIVE: To evaluate the association between serum activin A levels and prognosis in CAP patients.
METHODS: A total of 168 CAP individuals grouped according to the severity and prognosis of illness condition, and 48 healthy individuals as the control group were enrolled in this study. Circulating concentrations of activin A were measured using enzyme-linked immunoassays. The interaction between activin A levels and etiologies of CAP was determined. Based on the severity of CAP, 110 patients (65.48%) were categorized into group-I, 42 (25%) cases were grouped into group-II, and 16 (9.52%) cases were categorized into group-III.
RESULTS: Serum activin A levels were higher in patients with CAP than controls, but independent of etiology. Moreover, the scores of Pneumonia Severity Index (PSI) and CURB-65 positively correlated with the increasing levels of serum activin A, and were at their highest peak in individuals in group-III (P < 0.001). Combining activin A with CURB-65 or PSI was more effective in improving predictive property (P < 0.01). According to Cox proportional regression analysis, after adjusting clinical parameters, we confirmed that activin A showed a powerful predictive property for hospital mortality in CAP patients (P < 0.001).
CONCLUSIONS: Higher level of serum activin A was associated with poor prognosis of CAP. Activin A can be used as a more valuable biomarker of prognosis in CAP patients.
目的:评价CAP患者血清激活素A水平与预后的关系。
方法:根据病情的严重程度和预后,共168名CAP个体进行分组,48名健康个体作为对照组纳入本研究。活化素A的循环浓度使用酶联免疫测定法测量。确定了激活素A水平与CAP病因之间的相互作用。根据CAP的严重程度,110例患者(65.48%)被归类为第一组,42(25%)例分为II组,16例(9.52%)被归类为III组。
结果:CAP患者血清激活素A水平高于对照组,但与病因无关。此外,肺炎严重程度指数(PSI)和CURB-65评分与血清激活素A水平升高呈正相关,并在III组个体中达到最高峰(P<0.001)。结合活化素A与CURB-65或PSI在改善预测性质方面更有效(P<0.01)。根据Cox比例回归分析,在调整临床参数后,我们证实,激活素A对CAP患者的住院死亡率显示出强大的预测特性(P<0.001).
结论:血清激活素A水平升高与CAP预后不良相关。激活素A可作为CAP患者预后的更有价值的生物标志物。