Influenza A virus infection causes a series of diseases, but the factors associated with disease severity are not fully understood. Disruption of the endothelial glycocalyx contributes to acute lung injury in sepsis, but has not been well studied in H1N1 influenza. We aim to determine whether the plasma glycocalyx components levels are predictive of disease severity in H1N1 influenza. This prospective observational study included 53 patients with influenza A (H1N1) during the influenza season, and 30 healthy controls in our hospital. Patients were grouped by severity and survival. We collected clinical data and blood samples at admission. Inflammatory factors (tumor necrosis factor-α, interleukin-6, interleukin-10) and endothelial glycocalyx components (syndecan-1, hyaluronan, heparan sulfate) were measured. The plasma levels of syndecan-1, hyaluronan, and heparan sulfate were significantly higher in patients with severe influenza A (H1N1) than in mild cases. Syndecan-1 and hyaluronan were positively correlated with disease severity, which was indicated by the APACHE II and SOFA scores and lactate levels, and negatively correlated with albumin levels. At a cutoff point ≥ 173.9 ng/mL, syndecan-1 had a 81.3% sensitivity and 70.3% specificity for predicting of 28-day mortality. Kaplan – Meier analysis demonstrated a strong association between syndecan-1 levels and 28-day mortality (log-rank 11.04, P = 0.001). Elevated plasma levels of syndecan-1 has a potential role in systemic organ dysfunction and may be indicative of disease severity in patients with influenza A (H1N1).
【저자키워드】 viral infection, Predictive markers, 【초록키워드】 Diseases, Influenza, prospective observational study, severity, disease severity, hospital, 28-day mortality, interleukin-6, Sepsis, influenza A, acute lung injury, sensitivity, specificity, survival, Patient, organ dysfunction, plasma, H1N1, virus infection, Syndecan-1, H1N1 influenza, Admission, association, Lactate, Analysis, Disruption, APACHE II, Predictive, SOFA score, tumor necrosis factor-α, endothelial, Factor, Clinical data, healthy control, mild cases, blood sample, Cutoff, component, albumin levels, collected, indicated, determine, contribute, demonstrated, correlated, significantly higher, cause, were measured, patients with influenza, positively correlated, 【제목키워드】 plasma, H1N1, poor prognosis, influenza type A,