Predictive value of pentraxin-3 on disease severity and prognosis in patients with hemorrhagic fever with renal syndrome

Abstract

Background Pentraxin-3 is an acute-phase protein involved in the processes of inflammatory and infection. This study aimed to analyze the changes of plasma pentraxin-3 prospectively and evaluate its predictive value on disease severity and prognosis in patients with hemorrhagic fever with renal syndrome (HFRS). Methods 105 patients with HFRS admitted by the Second Affiliated Hospital of Air Force Medical University from October 2012 to December 2014 were randomly enrolled in this study. All patients were divided into a mild-type group (17 cases), a moderate-type group (27 cases), a severe-type group (26 cases) and a critical-type group (35 cases) according to the HFRS criteria for clinical classification. 96 venous blood samples of acute phase and 65 of convalescent phase were collected from patients during hospitalization, while venous blood samples of 27 healthy volunteers were taken as controls. The levels of plasma pentraxin-3 were detected using the enzyme linked immunosorbent assay (ELISA), and which were compared among the acute and convalescent phases in different types of patients, as well as the control group. Spearman correlation analysis was used to evaluate the correlation between pentraxin-3 and conventional laboratory parameters. The predictive effectiveness for prognosis of pentraxin-3 was evaluated by receiver operating characteristic (ROC) curve analysis. Results There was no significant difference in gender and age distribution between all types of patients and control group (P > 0.05). In all types of patients, the levels of pentraxin-3 in acute phase were significantly higher than that of control group and convalescent phase of the same type (P < 0.05). The levels of pentraxin-3 increased with the aggravation of the disease, and showed the highest expression in critical-type patients (P < 0.05). Pentraxin-3 was positively correlated with WBC, AST and APTT, and negatively correlated with PLT, ALB and Fib (|rs|>0.500, P < 0.001). Pentraxin-3 showed significant predictive value for the prognosis of patients with HFRS, with the area under ROC curve (AUC) of 0.753 (95%CI: 0.593 ~ 0.914, P = 0.003). Conclusions The detection of plasma pentraxin-3 can be beneficial to the evaluation of disease severity and prognosis in patients with HFRS.