Correlation between copeptin and the disease severity, outcome and stress hyperglycemia in severe pneumonia patients

Abstract

Objective To study the changes of plasma copeptin level in pneumonia patients and to explore the correlation between copeptin and disease severity, outcome as well as stress hyperglycemia. Methods A total of 45 patients with severe pneumonia were included in a prospective observation.The plasma levels of copeptin, CRP and blood glucose were measured after admission, and the APACHEⅡscores were recorded within 24 hours.The patients were given insulin therapy by intravenous micro-dosage pump, and the total doses of insulin were recorded.All the patients with 28-day survival were followed up. Results The plasma levels of copeptin of severe pneumonia patients after admission were positively correlated with APACHEⅡ(r=0.481, P=0.001)and blood glucose(r=0.417, P=0.004), and were also correlated with the total insulin doses in patients under insulin therapy(blood glucose≥10.0 mmol/L). The plasma levels of copeptin of the survival group were significanatly higher than the non-survival group, COX regression multivariate analysis showed that copeptin was an independent risk factor of death in severe pneumonia patients(P=0.005, OR=1.022, 95%CI: 1.00-1.044), and the area under the ROC curve was 0.740 9(P=0.006). Conclusion The plasma levels in all patients with copeptin of severe pneumonia after admission is positively correlated with APACHEⅡ and stress hyperglycemia, suggesting a useful approach to the judgment of disease severity, outcome and glucose control. Key words: Copeptin; Severe pneumonia; APACHEⅡ; Prognosi; Stress hyperglycemia