生物活性肾上腺髓质素作为急诊科疑似严重感染患者的护理点生物标志物：探索性分析
Bioactive adrenomedullin as a point-of-care biomarker in emergency department patients with suspected severe infections: an exploratory analysis.
摘要(中文译文)
背景：严重感染或脓毒症患者的早期识别和治疗仍然具有挑战性，且缺乏合适的生物标志物。本前瞻性探索性初步研究旨在评估床旁生物活性肾上腺髓质素（POC bio-ADM）在预测因疑似严重感染就诊于急诊科（ED）的患者中菌血症的潜力。次要目标包括其与任何感染、院内死亡率、重症监护病房（ICU）入住及ICU住院时间的关联。方法：在这项前瞻性探索性初步队列研究中，纳入了2022年12月至2023年9月期间就诊于德国一所大学医院急诊科的成年患者。采用单因素和多因素二元logistic回归分析POC bio-ADM水平，并与已确立的脓毒症生物标志物（PCT、CRP、乳酸）进行比较。结果：最终分析纳入47例患者。POC bio-ADM阳性（> 45 pg/ml）者占38.3%（95% CI：25.8–52.6%）。菌血症发生率为34.0%（95% CI：22.2–48.3%），78.7%（95% CI：65.1–88.8%）的患者存在感染。POC bio-ADM阳性与显著更高的菌血症发生率相关（55.6% vs. 20.7%）。在多因素分析中，POC bio-ADM阳性与菌血症的比值比（OR）为5.318（95% CI：1.217–23.243）。POC bio-ADM升高患者的归因院内死亡率更高（44.4% vs. 3.6%；OR：21.6，95% CI：2.4-195.3）。结论：这项小型、单中心初步探索性研究表明，POC bio-ADM可能有助于识别急诊科疑似严重感染患者中菌血症和院内死亡风险增加的患者；这些发现属于假设生成性质，需要在更大型队列中加以验证。
Abstract
BACKGROUND: Early identification and treatment of patients with severe infections or sepsis remains challenging, and suitable biomarkers are lacking. This prospective exploratory pilot study aimed to evaluate the potential of point-of-care bioactive adrenomedullin (POC bio-ADM) in predicting bacteremia in patients presenting to the emergency department (ED) with suspected severe infections. Secondary objectives included its association with any infection, in-hospital mortality, intensive care unit (ICU) admission, and ICU length of stay. METHODS: In this prospective exploratory pilot cohort study, adult patients presenting to the ED of a German university hospital between December 2022 and September 2023 were enrolled. POC bio-ADM levels were analyzed using univariate and multivariable binary logistic regression and compared to established sepsis biomarkers (PCT, CRP, lactate). RESULTS: 47 patients were included in the final analysis. POC bio-ADM was positive (> 45 pg/ml) in 38.3% (95% CI: 25.8–52.6%). Bacteremia was found in 34.0% (95% CI: 22.2–48.3%), and 78.7% (95% CI: 65.1–88.8%) had an infection. Positive POC bio-ADM was associated with significantly higher rates of bacteremia (55.6% vs. 20.7%). In the multivariable analysis, a positive POC bio-ADM was associated with an odds ratio (OR) of 5.318 (95% CI: 1.217–23.243) for bacteremia. Attributable in-hospital mortality was higher in patients with elevated POC bio-ADM (44.4% vs. 3.6%; OR: 21.6, 95% CI: 2.4-195.3). CONCLUSION: This small, single-centre pilot exploratory study suggests that POC bio-ADM may help identify ED patients with suspected severe infection at increased risk of bacteremia and in-hospital mortality; these findings are hypothesis-generating and require confirmation in larger cohorts.
如何引用
AMA
Constantin Maier-Stocker, Julian Hupf, Jillena Zinsser-Krys, Markus Zimmermann, Frank Hanses. Bioactive adrenomedullin as a point-of-care biomarker in emergency department patients with suspected severe infections: an exploratory analysis.. BMC infectious diseases. 2026; doi:10.1186/s12879-026-12951-1.
APA
Constantin Maier-Stocker, Julian Hupf, Jillena Zinsser-Krys, Markus Zimmermann, Frank Hanses (2026). Bioactive adrenomedullin as a point-of-care biomarker in emergency department patients with suspected severe infections: an exploratory analysis.. BMC infectious diseases. https://doi.org/10.1186/s12879-026-12951-1
GB/T 7714
Constantin Maier-Stocker, Julian Hupf, Jillena Zinsser-Krys, Markus Zimmermann, Frank Hanses. Bioactive adrenomedullin as a point-of-care biomarker in emergency department patients with suspected severe infections: an exploratory analysis.[J]. BMC infectious diseases, 2026 doi:10.1186/s12879-026-12951-1.
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