Outcome Prediction in Pneumonia Induced ALIARDS by Clinical Features and Peptide Patterns of BALF Determined by Mass Spectrometry 英文参考文献.docVIP

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Outcome Prediction in Pneumonia Induced ALIARDS by Clinical Features and Peptide Patterns of BALF Determined by Mass Spectrometry 英文参考文献.doc

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Outcome Prediction in Pneumonia Induced ALIARDS by Clinical Features and Peptide Patterns of BALF Determined by Mass Spectrometry 英文参考文献

OutcomePredictioninPneumoniaInducedALI/ARDSby ClinicalFeaturesandPeptidePatternsofBALF DeterminedbyMassSpectrometry JochenFrenzel1*,ChristianGessner2,TorstenSandvoss2,StefanHammerschmidt2 ,Wolfgang Schellenberger1,UlrichSack3,KlausEschrich1,HubertWirtz2 1Institute of Biochemistry, Medical Faculty, University of Leipzig, Leipzig, Germany, 2Department of Respiratory Medicine, University of Leipzig, Leipzig, Germany, 3InstituteofClinicalImmunology,UniversityofLeipzig,Leipzig,Germany Abstract Background:Peptidepatternsofbronchoalveolarlavagefluid(BALF)wereassumedtoreflectthecomplexpathologyof acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) better than clinical and inflammatory parameters and maybesuperiorforoutcomeprediction. Methodology/PrincipalFindings:AtraininggroupofpatientssufferingfromALI/ARDSwascompiledfromequalnumbers ofsurvivorsandnonsurvivors.Clinicalhistory,ventilationparameters,Murray’slunginjuryseverityscore(Murray’sLISS)and interleukins in BALF were gathered. In addition, samples of bronchoalveolar lavage fluid were analyzed by means of hydrophobic chromatography and MALDI-ToF mass spectrometry (MALDI-ToF MS). Receiver operating characteristic (ROC) analysis for each clinical and cytokine parameter revealed erleukin-8.diabetes mellitus.Murray’s LISS as the best outcome predictors. Outcome predicted on the basis of BALF levels of interleukin-6 resulted in 79.4% accuracy, 82.7% sensitivity and 76.1% specificity (area under the ROC curve, AUC, 0.853). Both clinical parameters and cytokines as well as peptide patterns determined by MALDI-ToF MS were analyzed by classification and regression tree (CART) analysis and support vector machine (SVM) algorithms. CART analysis including Murray’s LISS, interleukin-6 and interleukin-8 in combination was correct in 78.0%. MALDI-ToF MS of BALF peptides did not reveal a single identifiable biomarker for ARDS. However, classification of patients was successfully achieved based on the entire peptide pat