摘要
目的探讨血清可溶性髓样细胞触发受体1(sTREM-1)在脓毒症中的表达和临床应用价值。方法采用ELISA检测68例脓毒症患者、40例非感染全身炎症反应综合征(SIRS)患者和20例正常对照血清sTREM-1、降钙素原(PCT)、肿瘤坏死因子α(TNF-α)和白细胞介素10(IL-10)水平,免疫比浊法检测血清高敏C反应蛋白(hsCRP)水平,分析比较sTREM-1、PCT和hsCRP对脓毒症的诊断和预后判断价值。序贯器官衰竭估计(SOFA)评分系统评价脓毒症患者的严重程度,对sTREM-1、PCT和hsCRP与SOFA评分、TNF-α和IL-10之间分别进行相关分析。结果各组血清sTREM-1、PCT、hsCRP、IL-10水平和IL-10/TNF-α比值比较差异均有统计学意义(P<0.05);各组血清TNF-α水平比较差异无统计学意义(P>0.05)。脓毒症组sTREM-1、PCT及hsCRP水平较非感染SIRS组显著升高(P<0.05)。根据ROC曲线分析,sTREM-1、PCT和hsCRP对脓毒症及非感染SIRS进行诊断的曲线下面积(AUC)分别为0.772(95%CI 0.674～0.871)、0.718(95%CI 0.601～0.835)和0.664(95%CI 0.532～0.797)。脓毒症患者中死亡组sTREM-1和PCT水平较存活组显著升高(P<0.01),hsCRP水平与存活组间差异无统计学意义(P>0.05)。脓毒症患者sTREM-1水平与SOFA评分、血清IL-10和IL-10/TNF-α比值呈明显正相关(r值分别为0.453、0.301和0.417,P均<0.05);与血清TNF-α无明显相关性(P>0.05)。PCT与SOFA评分呈明显正相关(r=0.436,P<0.05);hsCRP与SOFA评分无明显相关性(P>0.05)。结论血清sTREM-1水平不但有助于脓毒症的诊断,而且在一定程度上能作为判断疾病严重程度及预后的指标。sTREM-1和PCT可能在脓毒症诊断、预后判断和病情评估方面优于hsCRP。
Objective To investigate the expression and clinical significance of soluble triggering receptor expression on myeloid cells-1（sTREM-1） in sepsis patients.Methods Serum concentrations of sTREM-1,procalcitonin（PCT）,tumor necrosis factor alpha（TNF-α） and interleukin-10（IL-10） were measured by enzyme-linked immunosorbent assay,while high sensitivity C-reactive protein（hsCRP） level was detected by immunoturbidimetry in 68 patients with sepsis,40 patients with no-infective SIRS,and 20 normal individuals.The diagnostic and prognostic value of sTREM-1 and its comparison with PCT and hsCRP were analyzed.The sequential organ failure assessment（SOFA） score system was used to evaluate the severity of sepsis.The relationship between sTREM-1,PCT,hsCRP ,SOFA score,TNF-α,and IL-10 of the sepsis patients was analyzed,respectively.Results The differences in the serum concentrations of sTREM-1,PCT,hsCRP,IL-10 and IL-10/TNF-α ratio had statistical significance among three groups（P0.05）.The differences in the serum concentration of TNF-α had no statistical significance among three groups（P0.05）.However,the serum levels of sTREM-1,PCT and hsCRP in the sepsis group were significantly higher than those in the SIRS group（P0.05）.The receiver operating characteristic curve（ROC） analysis showed the area under the curve（AUC） for sTREM-1,PCT and hsCRP were 0.772（95%CI 0.674-0.871）,0.718（95%CI 0.601-0.835） and 0.664（95%CI 0.532-0.797）,respectively.The serum levels of sTREM-1 and PCT in the non-survivors were significantly higher than the survivors in the sepsis group（P0.01）,but the differences in the serum concentration of hsCRP had no statistical significance between the non-survivors and the survivors in the sepsis group（P0.05）.There were significantly positive correlations between sTREM-1 and SOFA score,IL-10 or IL-10/TNF-α ratio（r value of 0.453,0.301,0.417,P0.05）,but no correlation between sTREM-1 and TNF-α（P0.05）.There was significantly positive correlation be
出处
《中国呼吸与危重监护杂志》
CAS
2011年第6期538-542,共5页
Chinese Journal of Respiratory and Critical Care Medicine
基金
首都医科大学附属北京安贞医院院长科技发展基金(编号:2010Z09)
关键词
脓毒症
可溶性髓样细胞触发受体1
降钙素原
高敏C反应蛋白
Sepsis
Soluble triggering receptor expression on myeloid cells-1
Procalcitonin
High sensitivity C-reactive protein
