plasma kallistatin levels in patients with severe community-acquired pneumonia例如社区获得性肺炎患者的血浆kallistatin水平严重.pdfVIP

Lin et al. Critical Care 2013, 17:R27 /content/17/1/R27 RESEARCH Open Access Plasma kallistatin levels in patients with severe community-acquired pneumonia 1* 2 3,4 1 5 5 4,6 Wei-Chieh Lin , Shiou-Ling Lu , Chiou-Feng Lin , Chang-Wen Chen , Lee Chao , Julie Chao and Yee-Shin Lin Abstract Introduction: Community-acquired pneumonia (CAP) requiring intensive care unit (ICU) treatment commonly causes acute respiratory failure with high mortality. Kallistatin, an endogenous tissue kallikrein inhibitor, has been reported to be protective in various human diseases. The aim of this study was to assess the correlations of kallistatin with other biomarkers and to determine whether kallistatin levels have a prognostic value in severe CAP. Methods: Plasma samples and clinical data were prospectively collected from 54 patients with severe CAP requiring ICU admission. Seventeen healthy control subjects were included for comparison. Plasma kallistatin, kallikrein, and other biomarkers of inflammation (tumor necrosis factor-a (TNF-a), interleukin (IL)-1b, IL-6, IL-8, C-reactive protein (CRP)), and anti-coagulation (protein C, anti-thrombin III) were measured on days 1 and 4 of ICU admission. Comparison between survivors (n = 41) and nonsurvivors (n = 13) was performed. Results: Plasma kallistatin was significantly consumed in severe CAP patients compared with healthy individuals. Lower day 1 kallistatin levels showed a strong trend toward increased mortality (P = 0.018) and higher day 1 CURB-65 scores (P = 0.004). Plasma kallistatin levels on day 1 of ICU admission were significantly decreased in patients who developed septic shock (P = 0.017) and who had acute respira