摘要
目的:探讨慢性阻塞性肺疾病急性加重期(AECOPD)患者血清中可溶性髓样细胞触发受体-1(sTREM-1)水平与炎症反应的关系以及对细菌感染的诊断价值。方法:选择2016年11月至2018年11月期间南京市中心医院呼吸内科AECOPD患者60例、COPD稳定期患者60例和健康志愿者60名进行回顾性分析。检测血清sTREM-1、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、降钙素原(PCT)、超敏C-反应蛋白(hs-CRP)水平、患者肺功能、慢性阻塞性肺疾病评估测试(CAT)。采用Pearson线性法分析AECOPD患者血清sTREM-1水平和各指标的关系。绘制受试者工作特征曲线,并计算sTREM-1和PCT诊断AECOPD患者细菌感染的曲线下面积(AUC)。结果:AECOPD组血清sTREM-1水平高于健康对照组和COPD稳定期组(F=113.547,P<0.05)。经Pearson相关性分析,AECOPD患者血清sTREM-1水平与炎性因子PCT、hs-CRP、TNF-α、IL-6水平呈正相关,与FEV 1/FVC呈负相关(P值均<0.05);随着CAT评分升高,血清sTREM-1水平也逐渐升高(F=37.356,P<0.05)。经受试者工作特征曲线分析,血清sTREM-1联合PCT诊断AECOPD患者细菌感染的AUC为0.911(95%CI:0.837~0.986),较各项单独指标的AUC均明显增加;敏感度和特异度分别为78.1%和96.4%。结论:AECOPD患者血清sTREM-1水平相较于健康对照组和COPD稳定组患者均有明显升高,与炎症介质呈正相关性,可用于AECOPD细菌感染的早期诊断。
Objective To investigate the correlation of serum soluble triggering receptor expressed on myeloid cells-1(sTREM-1)with inflammatory factors and the diagnostic value for bacterial infection in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods There were 60 AECOPD patients,60 stable COPD patients and 60 healthy cases in Nanjing Central Hospital from November 2016 to November 2018 enrolled into the study.The serum sTREM-1,tumor necrosisα(TNF-α),interleukin-6(IL-6),hypersensitivity C-reactive protein(hs-CRP),procalcitonin(PCT)levels,pulmonary function and chronic obstructive pulmonary disease assessment test(CAT)scores of all subjects were detected and compared.The relationship between sTREM-1 and other indexes in AECOPD patients were analyzed by Pearson method.The receiver operating characteristic curve of the subjects was drawn,and the area under the curve(AUC)of sTREM-1 and PCT in diagnosis of bacterial infection in AECOPD patients was calculated.Results The serum sTREM-1 levels in AECOPD group were higher than healthy group and stable COPD group(F=113.547,P<0.05),which was positively related with TNF-α,IL-6,hs-CRP and PCT levels and negatively related with FEV1/FVC by Pearson method(all P<0.05).With the increase of CAT score,serum sTREM-1 level also increased gradually(F=37.356,P<0.05).The AUC of sTREM-1 and PCT on bacterial infection of AECOPD patients was 0.911(95%CI:0.837-0.986),which was significantly higher than that of other independent indexes.And the sensitivity and specificity were respectively 78.1%and 96.4%.Conclusions The serum sTREM-1 levels in AECOPD patients were higher than that in stable COPD patients and healthy cases,which would be related with inflammatory mediators.The detection of sTREM-1 combined with PCT can be as early diagnostic indexes of bacterial infection in AECOPD patients.
作者
高春
高丽华
赵军
Gao Chun;Gao Lihua;Zhao Jun(Department of Respiratory Medicine,Nanjing Central Hospital,Nanjing 210008,China)
出处
《国际呼吸杂志》
2020年第19期1503-1509,共7页
International Journal of Respiration
关键词
肺疾病
慢性阻塞性
细菌感染
慢性阻塞性肺疾病急性加重期
可溶性髓样细胞触发受体1
炎症反应
Pulmonary disease,chronic obstructive
Bacterial infection
Acute exacerbation of chronic obstructive pulmonary disease
Soluble triggering receptor expressed on myeloid cells-1
Inflammation
