Diagnostic Value Of Heparin-binding Protein And Heparin-binding Protein-to-albumin Ratio For Community-acquired Pneumonia

ObjectivesCommunity-acquired pneumonia(CAP)prognosis can be significantly improved through early diagnosis and treatment.Plasma heparin-binding protein(HBP)and the heparin-binding protein-to-albumin ratio(HBP/Alb)have not been adequately studied in the early diagnosis of CAP.Our primary objective was to assess the diagnostic value of plasma HBP,HBP/Alb and traditional inflammatory markers in patients with CAP presenting to the emergency department,and our secondary objective was to investigate the effect of antibiotic administration prior to blood sampling on various inflammatory markers in CAP patients.MethodsWe enrolled 103 CAP patients admitted to the emergency department of Zhujiang Hospital,Southern Medical University,from January 2021 to August 2022.Retrospectively analyzed the patients’ clinical data,patients with CAP were divided into non-antibiotic group(n=24)and antibiotic group(n=79)based on whether or not they used antibiotics prior to blood sampling and laboratory tests.The control group was comprised of 52 non-infected patients admitted during the same period.Plasma HBP,serum procalcitonin(PCT),white blood cell count(WBC),neutrophil-to-lymphocyte ratio(NLR)and HBP/Alb levels were collected and compared within 24 hours of patient admission.The receiver operating characteristic(ROC)curve was plotted to assess the diagnostic value of each indicator for CAP patients.Utilizing the Kappa test,the consistency of each indicator used to evaluate CAP and clinical diagnosis was analyzed.Spearman correlation was used to analyze the correlation between plasma HBP and clinical indicators of CAP patients.ResultsPlasma HBP,serum PCT,WBC,NLR and HBP/Alb were all elevated in the CAP group in comparison to the control group(P<0.001).Plasma HBP and HBP/Alb had the highest diagnostic accuracy for CAP,the area under the ROC curve(AUC)were 0.931 and 0.938(P<0.0001),and the best cut-off values were 35.40 ng/mL and 0.87,respectively.In evaluating the consistency between CAP and clinical diagnostic,the Kappa values for HBP,PCT,WBC,NLR and HBP/Alb were 0.749,0.465,0.439,0.566 and 0.773,respectively.Spearman correlation analysis showed that plasma HBP was positively correlated with serum PCT,WBC,NLR and HBP/Alb in CAP patients(P<0.001).Plasma HBP,serum PCT,WBC,NLR and HBP/Alb levels did not differ statistically between non-antibiotic and antibiotic groups(P>0.05).ConclusionsThis study suggests that plasma HBP and HBP/Alb are promising inflammatory markers in the early diagnosis of CAP patients in the emergency department,and their diagnostic values are superior to those of the traditional markers PCT,WBC and NLR.In addition,the use of antibiotics prior to blood sampling may not affect the reliability of inflammatory indicators,including HBP,PCT,WBC,NLR and HBP/Alb,for CAP assessment.