| Abstract: | 背景:
本實驗的目的是判斷患有社區型肺炎（community-acquired pneumonia, CAP）之成年住院病患在接受抗生素治療前與治療後，其血漿基質細胞衍生因子-1（stromal-cell-derived factor 1, SDF-1）之濃度變化，並觀察社區型肺炎的嚴重程度與血漿SDF-1濃度的相關性。
材料及方法:
本研究是從2009年2月至12月，共招募121位受試者，其中61位成年社區型肺炎患者，分別在他們接受抗生素治療之前及之後，進行血液採樣，同時以60位健康者作為對照組，進行?聯免疫吸附試驗（enzyme-linked immunosorbent assay, ELISA），以測量血漿內SDF-1的濃度。本研究使用肺炎嚴重度指標值(pneumonia severity index, PSI)、CURB-65、以及急性生理和慢性健康評分（Acute Physiology and Chronic Health Evaluation II, APACHE II）來衡量社區型肺炎的嚴重程度。
結果:
與對照組相比，社區型肺炎患者在接受抗生素治療前的SDF-1濃度顯著上升，並且在接受治療後顯著下降。另外，白血球、嗜中性白血球、與CRP（C-reactive protein）也在病患接受抗生素治療後濃度顯著減少。然而，本實驗發現白血球與PSI、CURB-65、APACHE II score之間沒有顯著相關性。嗜中性白血球濃度或CRP濃度也沒有與PSI、CURB-65、APACHE II顯著相關性。此外，血漿SDF-1濃度之差異與PSI、CURB-65、APACHE II三者的分數皆達到顯著相關（分別為 r=0.389, p=0.002, n=61; r=0.449, p<0.001, n=61; r=0.363, p=0.004, n=61）。
結論:
本研究顯示SDF-1在社區型肺炎嚴重程度的臨床評估上扮演著重要角色，能夠提供治療方向及預測病人預後。SDF-1濃度能夠用來做為早期診斷社區型肺炎及檢測其嚴重性的指標。
關鍵字：SDF-1、社區型肺炎、血漿基質細胞衍生因子-1
Background:
To determine changes in the plasma levels of stromal-cell-derivedfactor-1 (SDF-1) before and after antibiotic treatment in hospitalized adult patients with community-acquired pneumonia(CAP), and observe the correlation between the severity of CAP and the plasma SDF-1 level.
Methods:
From Feb, 2009 to December, 2009, 121 cases were included in this study. We gathered blood specimens from 61 adult CAP patients before and after antibiotic treatment and from 60 healthy cases to measure the plasma concentrations of SDF-1 by using an enzyme-linked immunosorbent assay. Pneumonia severity index (PSI), CURB-65, and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were used to evaluate the severity of CAP.
Results:
The plasma SDF-1 concentrations were elevated significantly in patients with CAP before receiving treatment compared with the controls, and decreased significantly after receiving treatment. Leukocyte (WBC) and neutrophil counts, and C-reactive protein (CRP) levels, decreased significantly after antibiotic treatment. However, there was no significant correlation between WBC and any of PSI, CURB-65, or APACHE II scores. Such lack of significant correlation also applied to neutrophil or CRP level. Moreover, the plasma concentration of SDF-1 were significantly correlated with PSI, CURB-65, and APACHE II scores (r=0.389, p=0.002, n=61; r=0.449, p<0.001, n=61; r=0.363, p=0.004, n=61, respectively).
Conclusion:
Plasma SDF-1 can play a crucial role in the clinical assessment of the severity of CAP, and can potentially be used to guide the development of treatment methods and to predict clinical outcomes. An elevated plasma SDF-1 concentration can be used as a biological marker for the early diagnosis of CAP and for the early detection of its severity.
Keywords: stromal-cell-derived factor 1 (SDF-1); community-acquired pneumonia (CAP) |
