摘要
目的探讨成年重症肺炎合并呼吸衰竭患者血清中可溶性髓系细胞触发受体(sTREM-1)、Toll样受体4(TLR4)、血管细胞黏附分子1(VCAM-1)的表达及对预后的评估价值。方法选择2020年1月至2023年6月长沙市第四医院收治的80例成年重症肺炎合并呼吸衰竭患者进行研究,设为病例组,同时根据患者院内存活情况将66例存活患者设为预后良好组,将14例死亡患者设为预后不良组;选择同期本院治疗的单纯重症肺炎成年患者72例设为重症肺炎组,单纯呼吸衰竭成年患者73例设为呼吸衰竭组,分析各组患者血清sTREM-1、TLR4、VCAM-1水平变化情况及三组患者临床评分[临床肺部感染评分(CPIS)、急性生理和慢性健康(APACHEⅡ)评分],分析血清sTREM-1、TLR4、VCAM-1评估成年重症肺炎合并呼吸衰竭患者预后的价值。结果病例组患者血清sTREM-1、TLR4、VCAM-1水平显著高于重症肺炎组、呼吸衰竭组患者,重症肺炎组患者血清sTREM-1、TLR4、VCAM-1水平显著高于呼吸衰竭组患者(均P<0.01)。病例组患者CPIS及APACHEⅡ评分显著高于重症肺炎组、呼吸衰竭组患者,重症肺炎组患者CPIS及APACHEⅡ评分显著高于呼吸衰竭组患者(均P<0.01)。相关性分析结果显示,血清sTREM-1、TLR4、VCAM-1水平均与患者CPIS、APACHEⅡ评分之间呈正相关(均P<0.05)。预后不良组血清sTREM-1、TLR4、VCAM-1水平显著高于预后良好组(均P<0.05)。受试者工作特征(ROC)曲线分析结果显示,血清sTREM-1预测成年重症肺炎合并呼吸衰竭患者预后的ROC曲线下面积(AUC)为0.971,灵敏度为88.20%,特异度为91.20%;血清TLR4预测成年重症肺炎合并呼吸衰竭患者预后的AUC为0.966,灵敏度为87.80%,特异度为92.70%;血清VCAM-1预测成年重症肺炎合并呼吸衰竭患者预后的AUC为0.981,灵敏度为89.30%,特异度为93.60%(均P<0.05)。结论血清sTREM-1、TLR4、VCAM-1在成年重症肺炎合并呼吸衰竭患者中表达异常,且对患者预后有�
Objective To investigate the expression and prognostic value of serum soluble triggering receptors expressed on myeloid cells-1(sTREM-1),Toll like receptor 4(TLR4),and vascular cell adhesion molecule 1(VCAM-1)in adult patients with severe pneumonia complicated with respiratory failure.Methods A study was conducted on 80 adult patients with severe pneumonia and respiratory failure who underwent treatment at the Fourth Hospital of Changsha from January 2020 to June 2023.They were divided into a case group,and 66 surviving patients were divided into a good prognosis group and 14 deceased patients into a poor prognosis group based on their hospital survival;72 adult patients with severe pneumonia treated in our hospital during the same period were selected as the severe pneumonia group,and 73 adult patients with simple respiratory failure were selected as the respiratory failure group.The changes in serum sTREM-1,TLR4,and VCAM-1 levels in each group of patients were analyzed,as well as the clinical scores of the three groups of patients[Clinical Pulmonary Infection Score(CPIS),Acute Physiological and Chronic Health(APACHEⅡ)Score].The prognostic value of serum sTREM-1,TLR4,and VCAM-1 in evaluating the prognosis of adult severe pneumonia patients with respiratory failure was analyzed.Results The serum levels of sTREM-1,TLR4,and VCAM-1 in the case group were significantly higher than those in the severe pneumonia group and respiratory failure group.The serum levels of sTREM-1,TLR4,and VCAM-1 in the severe pneumonia group were significantly higher than those in the respiratory failure group(all P<0.01).The CPIS and APACHEⅡscores of patients in the case group were significantly higher than those in the severe pneumonia group and respiratory failure group.The CPIS and APACHEⅡscores of patients in the severe pneumonia group were significantly higher than those in the respiratory failure group(all P<0.01).The correlation analysis results showed that serum levels of sTREM-1,TLR4,and VCAM-1 were positively correlated wit
作者
田静
袁浩
Tian Jing;Yuan Hao(Department of Respiratory and Critical Care Medicine,the Fourth Hospital of Changsha,Changsha 410006,China)
出处
《中国医师杂志》
CAS
2024年第5期707-711,共5页
Journal of Chinese Physician
基金
湖南省卫生健康委科研计划项目(D202303026875)。
关键词
髓系细胞触发受体-1
Toll样受体4
血管细胞黏附分子1
重症肺炎
呼吸衰竭
Triggering receptor expressed on myeloid cells-1
Toll-like receptor 4
Vascular cell adhesion molecule-1
Severe pneumonia
Respiratory failure
