Lipocalin 2與社區型肺炎的相關性研究

Study of the lipocalin 2 in community-acquired pneumonia

葉元宏(Yuan-Hung Yeh)

指導教授 ： 楊順發

中山醫學大學/醫學院/醫學研究所/博士(2013年)

https://doi.org/10.6834/CSMU.2013.00233

摘要

本篇研究的主要目的為研究社區肺炎(community-acquired pneumonia, CAP)患者在抗生素治療前後，其血漿中lipocalin2 (LCN2)與LCN2和基質金屬蛋白水解酶-9 (matrix metalloproteinase-9, MMP-9)複合物的濃度變化。我們利用酵素連結免疫吸附法(enzyme-linked immunosorbent assay, ELISA)來觀察並偵測61個CAP患者與60個正常對照組血漿中LCN2與LCN2/MMP-9複合物的濃度。結果發現，白血球(white blood cells, WBCs)、嗜中性球(neutrophils)、C-reactive protein (CRP)、LCN2和LCN2/MMP-9複合物的濃度在經過抗生素治療後均下降。而血漿中LCN2濃度與評估CAP患者嚴重程度的三項指標:肺炎嚴重指數(pneumonia severity index, PSI)、CURB-65和Acute Physiology And Chronic Health Evaluation II (APACHE II)具有相關性(r = 0.333, p = 0.009 ; r = 0.288, p = 0.024 ; r = 0.328, p = 0.010)。此外，LCN2的濃度也與白血球、嗜中性球和LCN2/MMP-9複合物的濃度成正相關。因此，CAP患者血漿中LCN2和LCN2/MMP-9複合物可以當作生物指標來評估CAP的嚴重程度，且未來可以應用於治療成效評估。

關鍵字

社區肺炎 ； 肺炎嚴重指數 ； 基質金屬蛋白水解酶-9 ； LCN2

並列摘要

The aim of this study was to investigate the differential plasma levels of lipocalin 2(LCN2) and its complex with matrix metalloproteinase-9 (MMP-9) before and after antibiotic treatment in hospitalized adult patients with community-acquired pneumonia (CAP). Plasma LCN2 and LCN2/MMP-9 complex levels were measured in 61 adult patients with CAP and 60 healthy controls using commercial enzyme-linked immunosorbent assay (ELISA). A decrease in the number of white blood cells (WBCs) and neutrophils and decreases in the levels of c-reactive protein (CRP), LCN2, and LCN2/MMP-9 complex were observed after antibiotic treatment. The plasma level of LCN2, but not that of CRP, was correlated with the severity of CAP based on the Pneumonia Severity Index (PSI ; r = 0.333, p = 0.009), CURB-65 (r = 0.288, p = 0.024), and Acute Physiology And Chronic Health Evaluation II (APACHE II) scores (r = 0.328, p = 0.010). LCN2 levels were also significantly correlated with LCN-2/MMP-9 levels and the numbers of WBCs or neutrophils. Plasma levels of LCN2 and the LCN2/MMP-9 complex can act as adjuvant diagnostic biomarkers for CAP. Plasma LCN2 might play a further role in the clinical assessment of the severity of CAP, which could potentially guide the development of future treatment strategies.

並列關鍵字

community-acquired pneumonia ； neumonia severity index ； matrix metalloprotease-9 ； LCN2

參考文獻

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