Clinical Usefulness of Urinary Fatty Acid Binding Proteins in Assessing the Severity and Predicting Treatment Response of Pneumonia in Critically Ill Patients:A Cross-Sectional Study

• Main Authors: Tsung-Cheng Tsao, 曹琮琤
• Other Authors: Shi-Chuan Chang
• Format: Others
• Language: zh-TW
• Published: 2016
• Online Access: http://ndltd.ncl.edu.tw/handle/j7shg8

碩士 === 國立陽明大學 === 急重症醫學研究所 === 105 === Purpose: To investigate the clinical relevance of urinary fatty acid binding proteins (FABPs), including intestinal-FABP, adipocyte-FABP, liver-FABP and heart-FABP in pneumonia patients required admission to respiratory intensive care unit (RICU). Patients and Methods: Consecutive pneumonia patients who admitted to RICU from September 2013 to October 2014 were enrolled except for those with pneumonia for more than 24 hours before admission to RICU. Pneumonia patients were further divided into with and without septic shock subgroups. Twelve patients without infection were enrolled to serve as control group. Urine samples were collected on day 1 and day 7 after admission to RICU for measuring FABPs and inflammatory cytokines. Clinical and laboratory data were collected and compared between pneumonia and control groups, and between the pneumonia patients with and without septic shock. Results: There were no significant differences in urinary levels of various FABPs and inflammatory cytokines measured on day 1 between control and pneumonia groups. Urinary values of intestine-FABP (P=0.020), adipocyte-FABP (p=0.005), heart-FABP (p=0.025) and interleukin-6 (IL-6) (p=0.019) were significantly higher and arterial oxygen tension/fraction of inspired oxygen (PaO2/FiO2, P/F) ratio (p=0.024) was significantly lower in pneumonia patients with septic shock on day 1 than in those without septic shock. After multivariate analysis, adipocyte-FABP was the independent factor (p = 026). Urinary levels of FABPs measured on day 7 of pneumonia patients were significantly lower in the improved than in non-improved groups (p=0.030 for intestine-FABP, p=0.003 for adipocyte-FABP, p=0.010 for heart-FABP and p=0.008 for liver-FABP, respectively). After multivariate analysis, adipocyte-FABP was the independent factor (p=0.023). Conclusions: For pneumonia patients required admission to RICU, urinary levels of adipocyte-FABP on days 1 and 7 after admission to RICU may be valuable in assessing the pneumonia severity and in predicting treatment response, respectively. Further studies with larger populations are needed to verify these issues.