可溶性髓系细胞触发受体-1、降钙素原及超敏反应蛋白在脓毒血症诊断中的价值*
The value of Soluble triggering receptor -1, procalcitonin and high sensitive C-reactive protein in the diagnosis of sepsis

黄丹.可溶性髓系细胞触发受体-1、降钙素原及超敏反应蛋白在脓毒血症诊断中的价值*[J].内科急危重症杂志,2017,23(1):

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英文关键词:Soluble triggering recepter expression on myeloid cell-1 Procalcitonin C-reactive protein Sepsis

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作者	单位	E-mail
黄丹	成都医学院第一附属医院重症医学科四川成都 610500	huangdan854@163.com

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中文摘要:

【】目的探究可溶性髓系细胞触发受体-1(Soluble triggering recepter expression on myeloid cell-1, sTREM-1)、降钙素原(Procalcitonin, PCT)及超敏反应蛋白(C-reactive protein, CRP)在脓毒血症诊断中的价值。方法选取84例于2013年2月至2016年5月入我院诊治的脓毒血症患者作为脓毒血症组,另选同期36例非脓毒血症患者作为对照组,运用ELISA法检测所有患者血浆sTREM-1和PCT水平,运用免疫比浊法检测所有患者血浆CRP水平,运用序贯器官衰竭估计评分(Sequential Organ Failure Assessment Score,SOFA)对患者进行评分,并比较组间差异。结果脓毒血症组患者的血浆sTREM-1、PCT、CRP以及SOFA评分均显著高于对照组,差异具有统计学意义(t=8.81、6.92、9.32、22.50,P＜0.01)；脓毒血症患者各亚组间的血浆sTREM-1、PCT水平差异显著(F=16.79、30.89,P＜0.01),而组间CRP水平无显著差异(F=1.23,P=0.30)；sTREM-1、PCT、SOFA评分和CRP诊断脓毒血症的曲线下面积(AUC)由高到低分别为0.92、0.85、0.67、0.55,CRP诊断脓毒血症价值不高；死亡组患者的血浆sTREM-1、PCT水平随时间推移,变化不大(P＞0.05),生存组患者血浆sTREM-1、PCT水平随时间推移逐渐降低(P＜0.05),其第4、7天的血浆sTREM-1、PCT水平显著低于死亡组(P＜0.05),而CRP水平两组间无显著差异(P＞0.05)；脓毒血症组的sTREM-1、PCT和SOFA评分两两之间呈正相关关系(P＜0.05),而CRP与上述指标无显著相关性(P＞0.05)。结论相比于传统的PCT,血浆sTREM-1、PCT水平在脓毒血症患者的早期诊断方面具有更高的临床意义。

英文摘要:

【】 Objective To explore the value of Soluble triggering receptor -1, procalcitonin and high sensitive C-reactive protein in the diagnosis of sepsis.Methods 84 cases of children with sepsis from February 2013 to May 2016 in our hospital were Selected as sepsis group, and 36 cases of non septic patients were selected as control group. The plasma levels of sTREM-1 and PCT were detected by ELISA method. The plasma levels of CRP were detected by SOFA was used to assess the patient"s condition. Results The sTREM-1, PCT, CRP and SOFA of Sepsis group were significantly higher than those in control group(t=8.81, 6.92, 9.32, 22.50,P＜0.01). The sTREM-1 and PCT of subgroups wewe significantly different (F=16.79, 30.89, P < 0.01), but there were no difference in CRP (F=1.23, P=0.30). The area under the curve of sTREM-1, PCT, SOFA score and CRP from high to low were 0.92, 0.85, 0.67, 0.55. The diagnostic value of CRP was not significany. The sTREM-1, PCT OF death group did not change significantly over time (P > 0.05), and the sTREM-1, PCT of survival group decreased gradually (P < 0.05), and the sTREM-1 and PCT in 4th and 7th day were significantly lower than those in death group (P < 0.05), but there was no significant difference between the two groups in CRP(P > 0.05). The relationship between the sepsis group of sTREM-1, PCT and SOFA score were positively correlated(P < 0.05), and there was no significant correlation between CRP and other indexes(P > 0.05). Conclusions Compared with tPCT, sTREM-1, PCT are more significant in the early diagnosis of sepsis with children.