血漿中YKL-40 與社區型肺炎其嚴重程度的相關性研究

本研究主要探討社區型肺炎(community-acquired pneumonia ; CAP)患者在經抗生素治療前與治療後，血漿中YKL-40濃度的變化與其他肺炎指標的相關性。本實驗利用酵素連結免疫吸附法(enzyme-linked immunosorbent assay ; ELISA) 來偵測61個CAP患者與60個對照組，共121個血漿中YKL-40的濃度。結果發現C-reactive protein (CRP)、白血球(white blood cells; WBCs)、嗜中性白血球(neutrophils)、YKL-40的濃度在經過抗生素治療後皆有明顯的下降。另外，經統計發現血漿中YKL-40濃度與肺炎嚴重指數(Pneumonia Severity Index ; PSI)、Confusion, Uremia, Respiratory rate, Blood pressure, Age ≥ 65 years (CURB-65)、Acute Physiology And Chronic Health Evaluation II (APACHE II) scores等指標以及CAP患者的住院天數具有相關性(r = 0.630, p = 0.001 ; r = 0.640, p = 0.001 ; r = 0.539, p = 0.001 ; r = 0.321, p = 0.011)。此外，YKL-40的濃度與白血球、嗜中性白血球和CRP的濃度並無顯著相關性。因此，本實驗結果證明CAP患者血漿中YKL-40的濃度可以當作生物指標用來評估CAP患者的嚴重程度，並且希望未來可以在臨床應用於治療上的依據。

The aim of this study was to investigate the differential plasma levels of YKL-40 before and after antibiotic treatment in hospitalized adult patients with community-acquired pneumonia (CAP). Plasma YKL-40 level was measured in 61 adult patients with CAP and 60 healthy controls using commercial enzyme-linked immunosorbent assay (ELISA). A decrease in the levels of C-reactive protein (CRP) and neutrophils and decreases in the number of white blood cells (WBCs), and YKL-40 were observed after antibiotic treatment. The plasma level of YKL-40 was correlated with the severity of CAP based on the Pneumonia Severity Index (PSI; r = 0.630, p = 0.001), CURB-65 (r = 0.640, p = 0.001), Acute Physiology And Chronic Health Evaluation II (APACHE II) scores (r = 0.539, p = 0.001), and hospital length of stay (r = 0.321, p = 0.011). And YKL-40 levels were not significantly correlated with the numbers of WBCs or neutrophils, and CAP levels in the CAP patients before they received treatment. Plasma YKL-40 might play a further role in the clinical assessment of the severity of CAP, which could potentially guide the development of future treatment strategies.