The predictive value of serum neopterin for multiple organ dysfunction syndrome in severe burn patients

IF 0.5 4区 医学 Q4 BIOCHEMISTRY & MOLECULAR BIOLOGY Pteridines Pub Date : 2018-12-31 DOI:10.1515/pteridines-2018-0019
W. Xiong, J. Ouyang, Hai Ci, Wenping Jiang, W. Han, Yu Fu, Peigang Tian
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引用次数: 1

Abstract

Abstract Objective To investigate the predictive value of serum neopterin for multiple organ dysfunction syndrome (MODS) in severe burn patients. Methods Seventy-six severe burn patients with burns covering a total body surface area (TBSA) above 70% were included in this study. Of the 76 patients, 29 cases developed MODS (MODS group) and the remaining 47 subjects did not (non-MODS group). From the MODS group, 12 patients died (Death group) and 17 patients survived (Survive group). The serum level of neopterin in the MODS and non-MODS groups were examined by radioimmunoassay on following 1, 3 , 7 , 14 , 21 and 28 post-burn days (PBDs). A receiver operating characteristic (ROC) curve was used to analyse the predictive value of serum neopterin for MODS and death. Results The serum neopterin level in the MODS group was significantly higher than that of non-MODS group between 3~28 PBDs (p<0.001). However, the serum neopterin levels between the MODS and non-MODS groups following 1 PBD were not statistically significant (p>0.05). The best diagnostic performance of serum neopterin for MODS occurred 14 PBDs with the prediction sensitivity and specificity of 75.86% (56.46%~89.70%) and 85.11% (71.69%~93.80%) respectively. However, serum neopterin levels had no clinical value in predicting the death of MODS patients. The area under the ROC curve (AUC) was 0.72 (0.58~0.85), 0.81 (0.71~0.92) and 0.83 (0.72~0.94) for serum neopterin as biomarker in the prediction of MODS after 3, 7 and 14 PBDs, respectively. The AUCs were 0.50 (0.27~0.73), 0.53 (0.30~0.76) and 0.56 (0.33~0.79) for serum neopterin as biomarker in prediction of death for MODS patients after 3, 7 and 14 PBDs, respectively. Conclusion The persistent and significant increase of serum neopterin level is closely related to the development of MODS in patients with severe burns. Serum neopterin is therefore a promising serological marker for MODS early diagnosis, but has little efficacy in the prediction of the likelihood of death in severe burn patients with MODS.
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血清新蝶呤对严重烧伤患者多器官功能障碍综合征的预测价值
摘要目的探讨血清新蝶呤对严重烧伤患者多器官功能障碍综合征(MODS)的预测价值。方法对76例全身表面积(TBSA)大于70%的严重烧伤患者进行研究。76例患者中,29例发生MODS(MODS组),其余47例未发生MODS。MODS组死亡12例(死亡组),存活17例(存活组)。采用放射免疫分析法分别于烧伤后第1、3、7、14、21和28天(PBDs)检测MODS组和非MODS组血清新蝶呤水平。采用受试者工作特性(ROC)曲线分析血清新蝶呤对MODS和死亡的预测价值。结果MODS组血清新蝶呤水平在3~28个PBD之间明显高于非MODS组(p0.05),血清新蝶啶对MODS的最佳诊断表现为14个PBD,其预测敏感性和特异性分别为75.86%(56.46%~89.70%)和85.11%(71.69%~93.80%)。然而,血清新蝶呤水平在预测MODS患者死亡方面没有临床价值。血清新蝶呤作为生物标志物预测3、7和14个PBD后MODS的ROC曲线下面积(AUC)分别为0.72(0.58~0.85)、0.81(0.71~0.92)和0.83(0.72~0.94)。血清新蝶呤作为生物标志物预测MODS患者3、7和14个PBD后死亡的AUC分别为0.50(0.27~0.73)、0.53(0.30~0.76)和0.56(0.33~0.79)。结论严重烧伤患者血清新蝶呤水平持续显著升高与MODS的发生密切相关。因此,血清新蝶呤是一种很有前途的MODS早期诊断血清学标志物,但在预测严重烧伤MODS患者的死亡可能性方面收效甚微。
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来源期刊
Pteridines
Pteridines 生物-生化与分子生物学
CiteScore
1.20
自引率
25.00%
发文量
6
审稿时长
>12 weeks
期刊介绍: Pteridines is an open acess international quarterly journal dealing with all aspects of pteridine research. Pteridines are heterocyclic fused ring compounds involved in a wide range of biological functions from the color on butterfly wings to cofactors in enzyme catalysis to essential vitamins. Of the pteridines, 5,6,7,8-tetrahydrobiopterin is the necessary cofactor of several aromatic amino acid monoxygenases, the nitric oxide synthases and glyceryl ether monoxygenase (GEMO). Neopterin plays an essential role in the immune system and is an important biomarker in laboratory medicine for diseases such as HIV, cardiovascular disease, malignant tumors, among others. Topics: -Neopterin, dihydroneopterin, monapterin- Biopterin, tetrahydrobiopterin- Folates, antifolates, riboflavin- Phenylalanine, tyrosine, phenylketonuria, serotonin, adrenalin, noradrenalin, L-DOPA, dopamine, related biogenic amines- Phenylalanine hydroxylase, tyrosine hydroxylase, tryptophan hydroxylase, nitric oxide synthases (iNOS), alkylglycerol monooxygenase (AGMO), dihydropterin reductase, sepiapterin reductase- Homocysteine, mediators of inflammation, redox systems, iron.
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