血清降钙素原在细菌感染中的临床应用研究

目的探讨血清降钙素原(PCT)作为细菌感染标志物在临床的应用价值。方法采用队列研究方法对该院2013年8月至2015年12月的脓毒血症组32例、非感染性全身炎症反应综合征(SIRS)组32例、对照组32例的血清PCT、C反应蛋白(CRP)、白细胞计数(WBC)和中性粒细胞百分率(NEUT%)进行检测,并对脓毒血症组进行抗菌药物治疗后动态检测,统计分析对细菌感染诊断的特异度、灵敏度。结果脓毒血症组血清PCT水平显著高于非感染性SIRS组和对照组(P0.05);脓毒血症组CRP、WBC、NEUT%与非感染性SIRS组比较差异无统计学意义(P0.05),但均高于对照组(P0.05)。脓毒血症组经抗菌药物治疗后,血清PCT水平显著降低(P0.05);CRP、WBC与NEUT%均保持较高水平,差异无统计学意义(P0.05)。PCT对细菌性感染诊断的灵敏度与特异度分别100.0%和93.8%,与CRP、WBC和NEUT%比较差异有统计学意义(P0.05)。结论血清PCT对细菌性感染诊断具有良好的灵敏度和特异度,同时能够反映细菌感染的严重程度和抗菌药物的治疗效果。CRP、WBC和NEUT%对细菌性感染诊断特异度较差,但不失为一个炎性指标。     

降钙素原对老年患者脓毒症的诊断价值

区分感染与非感染因素引起的全身性炎症反应综合征( SIRS)、脓毒症及脓毒性休克对早期诊断、判断患者预后及提高患者生存率非常重要。脓毒症与非感染性SIRS的临床表现相似,但治疗与预后不同。目前常用的脓毒症临床和实验室诊断指标特异性有限,降钙素原( PCT)作为一种全身细菌感染的新指标,与其他临床传统炎症指标相比,显示出较高的特异性与敏感性。本实验的目的是了解PCT对脓毒症的早期诊断价值。表1　两组患者体温、PCT评分及细胞学分析比较( x±s)组别例数(例) PCT评分(分)白细胞(×1 0 9/ L)中性粒细胞分类体温(℃)脓毒症组　　…     

血清降钙素原在全身炎症反应综合征中的临床应用

目的评价血清降钙素原(PCT)在全身炎症反应综合征(SIRS)病原学诊断及病情严重程度判断中的价值。方法选择2008年11月至2009年11月我院儿科收治的SIRS的患儿66例,根据病原学检测结果分为细菌性感染组(43例)和非细菌感染组(23例)。比较两组间PCT、超敏C-反应蛋白(hs-CRP)、白细胞(WBC)计数、中性粒细胞的差别及PCT与危重评分的相关性。结果细菌性感染组的PCT值明显高于非细菌感染组(P0.05),但两组hs-CRP、WBC计数、中性粒细胞水平比较差异无统计学意义(P0.05)。血清PCT水平与小儿危重病例评分呈负相关(r=-0.812,P0.05)。结论脓毒血症患者PCT对病原学诊断方面,血清PCT的价值优于hs-CRP、WBC计数、中性粒细胞比例,是敏感的血清学标志;PCT水平和细菌感染所致的SIRS患儿的严重程度相关。     

血清降钙素原水平在脓毒症患者中表达的意义

目的 研究血清降钙素原(PCT)在脓毒症诊断、鉴别诊断及病情严重程度评价中的价值.方法 将2005年11月至2008年11月入住我院儿科的脓毒症患儿76例分为细菌性脓毒症组48例和病毒性脓毒症组28例.比较2组PCT、CRP、WBC计数、中性粒细胞比例(N)、危重评分的差别;用ROC曲线评价其诊断价值;计算PCT与危重评分的相关性.结果 细菌性脓毒症组的PCT值明显高于病毒性脓毒症组,差异有统计学意义[(3.25±1.14)μg/L与(0.383±0.26)μg/L,t=13.02,P<0.01].但2组CRP[(10.90±4.53)mg/L与(9.79±2.45)mg/L]、WBC计数[(11.50±5.69)109/L与(10.43±4.03)109/L]、N[(77.15±6.31)%与(74.11±7.47)%]、危重评分[(81.75±6.81)分与(84.39±6.58)分]比较差异均无统计学意义(P均>0.05);当PCT≥2.0 μg/L时诊断细菌性脓毒症的敏感性、特异性分别为97%和95%,ROC曲线下面积为0.847;血清PCT水平与小儿危重病例评分呈显著负相关(r=-0.832,P<0.05).结论 PCT是诊断细菌性脓毒症灵敏的指标.     

降钙素原在急性胰腺炎诊断中的应用价值

目的探讨降钙素原(PCT)在急性胰腺炎诊断中的应用价值。方法将急性胰腺炎患者分为全身炎症反应综合征(SIRS)组与非SIRS组,本文对2010年1月至2011年10月收治的46例非SIRS组急性胰腺炎患者与11例SIRS组急性胰腺炎患者进行了血清PCT、C反应蛋白(CRP)和白细胞(WBC)计数的检测,并比较两组在第1、7、14天不同时段时血清PCT水平。结果 SIRS组急性胰腺炎患者的血清PCT水平明显高于非SIRS组急性胰腺炎患者,差异有统计学意义(P<0.01),CRP及WBC差异无统计学意义(P>0.05)。结论血清PCT检测可以有效判断急性胰腺炎患者感染的严重程度,为急性胰腺炎患者早期诊治提供了指导,有很高的临床应用价值。     

降钙素元结合SOFA评分在小儿脓毒症的诊断及预后的应用研究

目的 探讨血清降钙素元(PCT)及SOFA评分动态监测对小儿脓毒症的早期诊断并判断预后效果.方法 55例脓毒症患儿入院后24h内进行血常规、痰培养、外周血培养和X线胸片等常规检测;测定肝、肾功能,电解质,动脉血气;体温、白细胞计数、中性粒细胞计数、中性粒细胞比例;测定血清C反应蛋白(CRP)、PCT;进行SOFA评分.并于入院后第4、7天同样采集上述指标,并随访28d.对照组患儿均来自PICU危重患儿.结果 入院后三组患儿相关炎症指标比较可见死亡组及存活组的WBC,中性粒细胞,CRP及PCT均显著高于对照组,但死亡组及存活组两组间差异均无统计学意义.存活组在第4天及第7天较死亡组炎症指标及SOFA评分均明显下降,差异有统计学意义(P<0.05).结论 在早期小儿脓毒症中,PCT的大小与病情的轻重相关;在判断预后方面,需结合PCT及SOFA评分才能得到更准确的结果.     

C反应蛋白、降钙素原、中性粒细胞表面CD35和CD64诊断脓毒症的临床价值

目的比较C反应蛋白、降钙素原、中性粒细胞表面CD35和CD64诊断脓毒症的临床价值。方法选取2015年2月到2015年9月于首都医科大学附属北京友谊医院内科住院患者中脓毒症、非感染性全身炎症反应(SIRS)患者及同期随机选择体检中心体检者。抽取患者入院第一天血作为标本,通过流式细胞术测定中性粒细胞表面CD35和CD64;散射比浊法测定C反应蛋白(CRP);免疫色谱检测法测定血清中的降钙素原(PCT)浓度。利用SPSS 22.0统计软件对上述资料进行单因素和多因素分析。结果共入组61例研究对象,其中健康对照组17例,SIRS组15例和脓毒症组29例,CRP、PCT和CD35在SIRS组和脓毒症组差异未达到统计学意义(P=0.193,0.921和0.198);而CD64在SIRS组和脓毒症组差异达到统计学意义(P=0.000);ROC曲线显示CRP、PCT、CD35和CD64曲线下面积分别为0.601,0.509,0.620和0.901。根据ROC曲线计算的CD64区别全身炎症反应综合征(SIRS)组与脓毒症组的诊断界值为130MFI,敏感度为75.9%,特异度93.3%。结论相比于CRP、PCT和CD35,CD64能很好地区分SIRS患者和脓毒症患者。     

降钙素原与感染严重程度及疗效的相关性分析

目的探讨血清降钙素原(PCT)在细菌感染严重程度以及在抗感染治疗疗效监测中的临床应用价值。方法回顾性分析惠州市第一人民医院2016年1月～2017年10月就诊的可疑细菌感染住院患者(541例)血清PCT、C反应蛋白(CRP)、白细胞计数(WBC)、中性粒细胞百分率(NEUT%)、中性粒细胞计数(NEUT),并对脓毒血症组患者急性抗感染治疗前后进行检测,统计分析PCT对细菌感染的诊断价值和疗效监测的意义。结果感染性疾病组CRP为10.23±2.47mg/L,PCT为10.55±1.67mg/L显著高于对照组(P0.01),而WBC、NEUT%、NEUT与对照组相比较差异无统计学意义(P0.05)。脓毒血症患者血清PCT为16.45±1.17mg/L,显著高于非感染SIRS组5.21±1.21mg/L(P0.01);脓毒症患者治疗7d后PCT随病情好转显著降低(P0.01)。结论血清PCT能够鉴别诊断感染性疾病,同时能够鉴别诊断脓毒血症和判断抗感染的治疗效果,是临床上诊断细菌感染的敏感指标。     

血清降钙素原在感染性疾病患儿中的诊断价值

目的探讨降钙素原(PCT)对早期诊断细菌感染的临床研究。方法 116例发热患儿,其中细菌感染组42例(A组),病毒感染组38例(B组),非感染组36例(C组)。入院后立即检测PCT、C反应蛋白(CRP)、WBC计数、中性粒细胞比例。结果 A组的PCT水平明显高于B组及C组(均P<0.05);B组及C组间PCT、CRP、WBC计数、中性粒细胞比例水平差异无统计学意义(均P>0.05)。结论在诊断细菌感染时,血清PCT检测优于CRP、WBC计数、中性粒细胞比例,是敏感的血清学标志;PCT诊断病毒感染及非感染时无意义。     

降钙素原水平与其他炎症指标在炎症诊断中的比较研究

目的分析降钙素原(PCT)与相关炎症指标的关系。方法入住本院的262例患者进行PCT及白细胞(WBC)计数、中性粒细胞百分比(NE%)、红细胞沉降率(ESR)、C反应蛋白(CRP)、超敏C反应蛋白(hs-CRP)等炎症指标检测,按照PCT水平将患者分为A~E 5组,比较各组各项指标水平。结果随着PCT水平的升高,患者NE%、CRP、hs-CRP呈升高趋势。结论 PCT较其他炎症指标更能反映炎症的状态。     

Diagnostic value of procalcitonin levels as an early indicator of sepsis

Researchers and clinicians have been investigating and implementing various methods of early diagnosis for sepsis before documentation of infection. The aim of this study was to outline the efficiency of procalcitonin (PCT), C-reactive protein (CRP), and white blood cell count (WBC) in determining the early diagnosis of sepsis in the emergency department. Between January 1999 and September 2000, 34 patients with signs of systemic inflammatory response syndrome (SIRS) were enrolled in the study. The patients were divided into 2 groups according to non-suspected sepsis and suspected sepsis clinically. Admission PCT was significantly higher in suspected sepsis group (median 68.7 microg/L; lower [L] = 15.24 microg/L, upper [U] = 120.54 microg/L) compared with the unsuspected sepsis group (.23 microg/L; L =.10 microg/L, U =.44 microg/L). PCT values were compared with WBC and CRP levels. Predictive accuracy for sepsis expressed as area under the receiver operating characteristic (ROC) curve was.88 for PCT,.44 for WBC, and.34 for CRP. PCT can probably be used as a predictive marker in bacterial infections in emergency departments.     

Procalcitonin and C-reactive protein as markers of systemic inflammatory response syndrome severity in critically ill children

OBJECTIVES: To analyse the clinical value of procalcitonin (PCT), C-reactive protein (CRP) and leucocyte count in the diagnosis of paediatric sepsis and in the stratification of patients according to severity. DESIGN: Prospective, observational study. SETTING: Paediatric intensive care unit (PICU). PATIENTS: Ninety-four children. MEASUREMENT AND RESULTS: Leucocyte count, PCT and CRP were measured when considered necessary during the PICU stay. Patients were classified, when PCT and CRP were measured, into one of six categories (negative, SIRS, localized infection, sepsis, severe sepsis, and septic shock) according to the definitions of the American College of Chest Physicians /Society of Critical Care Medicine. A total of 359 patient day episodes were obtained. Leucocyte count did not differ across the six diagnostic classes considered. Median plasma PCT concentrations were 0.17, 0.43, 0.79, 1.80, 15.40 and 19.13 ng/ml in negative, systemic inflammatory response syndrome (SIRS), localized infection, sepsis, severe sepsis, and septic shock groups, respectively, whereas median plasma CRP concentrations were 1.35, 3.80, 6.45, 5.70, 7.60 and 16.2 mg/dl, respectively. The area under the ROC curve for the diagnosis of septic patients was 0.532 for leucocyte count (95% CI, 0.462-0.602), 0.750 for CRP (95% CI, 0.699-0.802) and 0.912 for PCT (95% CI, 0.882-0.943). We obtained four groups using CRP values and five groups using PCT values that classified a significant percentage of patients according to the severity of the different SIRS groups. CONCLUSIONS: PCT is a better diagnostic marker of sepsis in critically ill children than CRP. The CRP, and especially PCT, may become a helpful clinical tool to stratify patients with SIRS according to disease severity.     

PCT及sTREM-1检测在老年SIRS患者中的临床应用

目的 探讨检测老年全身炎症反应综合征（SIRS）患者血清中降钙素原（PCT）及可溶性髓样细胞触发性受体-1（sTREM-1）的临床应用价值.方法 89例临床诊断为老年SIRS患者为SIRS组,其中发展为多器官功能障碍综合征（MODS）的患者27例为MODS组,40例健康体检者为对照组,用酶联免疫分析法检测PCT及sTREM-1,同时采集抗凝血检测白细胞.比较SIRS组、MODS组及对照组间上述各指标的差异.结果 SIRS组、MODS组的血清PCT、sTREM-1的水平及白细胞计数均明显高于对照组（P均＜0.01）;MODS组的PCT和sTREM-1水平明显高于SIRS组（P＜0.05,P＜0.01）,白细胞计数两者相近（P＞0.05）.结论 血清中PCT、sTREM-1水平在SIRS、MODS患者及正常人中差异显著,二者均可作为老年SIRS的早期诊断和病情判定指标.     

可溶性髓样细胞触发受体-1对脓毒血症早期诊断价值

目的探讨可溶性髓样细胞触发受体-1(soluble triggering receptor expressed on myeloid cells-1,sTREM-1)对脓毒血症的早期诊断价值。方法 81例全身炎症反应综合征患者,根据脓毒血症诊断标准分为脓毒血症组35例与SIRS组46例,选择体检健康者30名为对照组,检测3组血清sTREM-1、降钙素原(procalcitonin,PCT)、C反应蛋白(C reactive protein,CRP)水平。结果脓毒血症组与SIRS组患者血清sTREM-1,PCT及CRP水平均高于对照组(P<0.05);脓毒血症组血清sTREM-1与PCT水平高于SIRS组(P<0.05),CRP水平与SIRS组比较差异无统计学意义(P>0.05)。结论血清sTREM-1是脓毒血症早期诊断的辅助指标,其灵敏度和特异性高于PCT和CRP。     

血清降钙素原和常用炎症指标结合SOFA评分对脓毒症早期诊断和预后价值的评价

目的 结合感染相关器官功能衰竭评分(SOFA)评价血清降钙素原(PCT)和临床常用炎症指标对脓毒症的早期诊断和预后价值.方法 采用前瞻性、临床病例观察及诊断试验研究.根据美国胸科医师协会/危重病医学会(ACCP/SCCM)共识会议,严格将入选病例分为全身炎症反应综合征(SIRS)组、脓毒症组、严重脓毒症组、脓毒性休克组、非SIRS对照组.测定24 h内的炎症指标、SOFA评分及PCT浓度并进行相关分析.结果 208例患者入选,其中对照组59例,SIRS组57例,脓毒症组52例,严重脓毒症组28例,脓毒性休克组12例.血清PCT浓度与脓毒症严重程度呈正相关,Spearman相关系数为0.909(P=0.000).根据受试者工作特征曲线(ROC曲线)分析,PCT的ROC曲线下面积(AUC)为0.936±0.020,SOFA评分的AUC为0.973±0.011(P均=0.000).判断最佳诊断界值PCT为＞0.375 μg/L,SOFA评分为＞3.5分,其约登(Youden)指数分别为0.808和0.801.二分类Logistic回归分析显示,在排除了年龄、CRP混杂因素后PCT和SOFA评分与脓毒症发病明显相关,相对危险度(OR值)分别为84.794和10.761(P均=0.000),并且可以预测脓毒症的发病概率.SOFA评分是脓毒症疾病预后的最显著因子,OR值为2.084(P=0.000 2).结论 传统炎症指标和C-反应蛋白(CRP)是鉴别SIRS和非SIRS的有用指标,但不是早期诊断脓毒症的可靠指标.PCT是早期诊断脓毒症并能与SIRS鉴别的特异性较高的炎症指标;结合SOFA评分和PCT可以预测脓度症的发病概率;根据PCT值的变化,再结合SOFA评分可以客观判断脓毒症病情的严重性.SOFA评分与脓毒症预后明显相关.     

降钙素原对脓毒症的早期诊断价值

目的　评价血清降钙素原 (PCT)在脓毒症 (Sepsis)病人早期诊断和治疗中的意义。方法　对重症监护病房 (ICU )内 160例危重病人进行前瞻性研究 ,按照全身炎症反应综合症 (SIRS)的定义 (ACCP/SCCM ) ,将病人分为四组 :对照组2 0例、SIRS组 5 0例、血培养阴性脓毒症组 46例、血培养阳性脓毒症组 44例。在入院第 1天记录每例病人的急性生理与慢性健康评分 (APACHE Ⅱscore)、临床和生理指标及血清PCT和C 反应蛋白 (CRP)浓度。结果　血清PCT浓度在脓毒症组与非脓毒症组之间存在显著性差异 (P <0 .0 0 0 1) ,在血培养阳性脓毒症组与血培养阴性脓毒症组之间亦存在显著性差异 (P <0 .0 5 )。而在对照组与SIRS组之间无显著性差异 (P >0 .5 )。血清PCT >2 .0ng/ml即可诊断脓毒症 ,其灵敏度和特异性分别为 93 .3 %和 10 0 % ,血清PCT >10ng/ml即可诊断菌血症 ,其灵敏度和特异性分别为 88.9%和85 .6%。结论　PCT是诊断脓毒症的一个新的主要指标之一。对ICU危重病人常规检测PCT有助于脓毒症的早期诊断和合理治疗。     

Procalcitonin: a valuable indicator of infection in a medical ICU?

OBJECTIVE: To assess the use of procalcitonin (PCT) for the diagnosis of infection in a medical ICU. DESIGN: Prospective, observational study. PATIENTS: Seventy-seven infected patients and 24 patients with systemic inflammatory response syndrome (SIRS) due to other causes. Seventy-five patients could be classified into sepsis (n = 24), severe sepsis (n = 27) and septic shock (n = 24), and 20 SIRS patients remained free from infection during the study. Plasma PCT and C-reactive protein (CRP) levels were evaluated within 48 h of admission (day 0), at day 2 and day 4. RESULTS: As compared with SIRS, PCT and CRP levels at day 0 were higher in infected patients, regardless of the severity of sepsis (25.2 +/- 54.2 ng/ml vs 4.8 +/- 8.7 ng/ml; 159 +/- 92 mg/l vs 71 +/- 58 mg/l, respectively). At cut-off values of 2 ng/ml (PCT) and 100 mg/l (CRP), sensitivity and specificity were 65% and 70% (PCT), 74% and 74% (CRP). PCT and CRP levels were significantly more elevated in septic shock (38.5 +/- 59.1 ng/ml and 173 +/- 98 mg/l) than in SIRS (3.8 +/- 6.9 ng/ml and 70 +/- 48 mg/l), sepsis (1.3 +/- 2.7 ng/ml and 98 +/- 76 mg/l) and severe sepsis (9.1 +/- 18. 2 ng/ml and 145 +/- 70 mg/l) (all p = 0.005). CRP, but not PCT, levels were more elevated in severe sepsis than in SIRS (p<0.0001). Higher PCT levels in the patients with four dysfunctional organs and higher PCT and CRP levels in nonsurvivors may only reflect the marked inflammatory response to septic shock. CONCLUSION: In this study, PCT and CRP had poor sensitivity and specificity for the diagnosis of infection. PCT did not clearly discriminate SIRS from sepsis or severe sepsis.     

Prognostic and diagnostic value of eosinopenia,C-reactive protein,procalcitonin, and circulating cell-free DNA in critically ill patients admitted with suspicion of sepsis

Introduction

The aims of this study were to assess the reliability of circulating cell-free DNA (cf-DNA) concentrations, compared with C-reactive protein (CRP), procalcitonin (PCT) and eosinophil count, in the diagnosis of infections in patients with systemic inflammatory response syndrome (SIRS) and their prognostic values in a cohort of critically ill patients.

Methods

We conducted a prospective cohort study in a medical-surgical intensive care unit of a university hospital. Eosinophil count and concentrations of cf-DNA, CRP, and PCT were measured in patients who fulfilled SIRS criteria at admission to the intensive care unit (ICU) and a second determination 24 hours later. DNA levels were determined by a PCR method using primers for the human beta-haemoglobin gene.

Results

One hundred and sixty consecutive patients were included: 43 SIRS without sepsis and 117 with sepsis. Levels of CRP and PCT, but not cf-DNA or eosinophil count, were significantly higher in patients with sepsis than in SIRS-no sepsis group on days 1 and 2. PCT on day 1 achieves the best area under the curve (AUC) for sepsis diagnosis (0.87; 95% confidence interval = 0.81-0.94). Levels of cf-DNA do not predict outcome and the accuracy of these biomarkers for mortality prediction was lower than that shown by APACHE II score. PCT decreases significantly from day 1 to day 2 in survivors in the entire cohort and in patients with sepsis without significant changes in the other biomarkers.

Conclusions

Our data do not support the clinical utility of cf-DNA measurement in critical care patients with SIRS. PCT is of value especially for infection identification in patients with SIRS at admission to the ICU.     

C-reactive protein as an indicator of sepsis

Objective: To determine the use of plasma C-reactive protein (CRP) concentrations, body temperature (BT) and white blood cell count (WBC) in the detection of sepsis in critically ill patients. Design: All patients admitted for more than 24 h in the intensive care unit (ICU) were prospectively included. Patients were followed up to ICU discharge and each patient-day was classified in one of four categories according to the infectious status: 1) Negative, patient-day without systemic inflammatory response syndrome (SIRS); 2) Definite, patient-day with SIRS and a positive culture; 3) SIRS, patient-day with SIRS and negative or no cultures. The last group was subdivided according to the following criteria: a) new, or persistence of, pulmonary infiltrates, b) the presence of pus in a place known to be sterile. Patient-days without these criteria were classified as SIRS with improbable sepsis (Unlikely), and with one criteria or more as SIRS with probable sepsis (Probable). Setting: Medical/surgical intensive care unit. Patients: Twenty-three patients were followed. Measurements and results: A total of 306 patient-days were analysed: 20 Negative, 15 Definite, 63 Unlikely and 208 Probable. The median (range) CRP values for Negative, Unlikely, Probable and Definite groups were as follows: 24.5 (7–86), 34 (5–107), 143 (39–544), and 148 (52–320) mg/l. The plasma CRP levels were significantly related to the infectious status (Negative, Unlikely, Probable or Definite) of the patient-day classification (p < 0.05). Concentrations of CRP in the Negative and Unlikely groups were significantly lower than in the Probable and Definite ones (p < 0.05). A plasma CRP of 50 mg/l or more was highly suggestive of sepsis (sensitivity 98.5 %, specificity 75 %). Conclusions: Daily measurement of CRP is useful in the detection of sepsis and it is more sensitive than the currently used markers, such as BT and WBC. Received: 22 December 1997 Accepted: 8 July 1998     

血浆可溶性髓样细胞触发受体-1对脓毒症早期诊断的价值及预后意义

目的 探讨血浆可溶性髓样细胞触发受体-1(soluble triggering receptor expressed on myeloid cells-1,sTREM-1)对脓毒症早期诊断的价值及预后意义。方法 采用前瞻性病例对照研究。将2009年5月至2010年6月天津医科大学第二医院重症监护病房( ICU)收治的56例系统性炎症反应综合征(SIRS)患者,根据2001年国际脓毒症会议诊断标准分为脓毒症组32例、SIRS组24例,同时收集非SIRS患者25例作为对照组,根据28 d转归将脓毒症组分为生存组和死亡组两个亚组。入院24h内测定血常规、血气分析、血生化、降钙素原（PCT）、C反应蛋白(CRP),记录最高体温(T),进行急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分;采用酶联免疫吸附法(ELISA)检测sTREM-1水平。采用SPSS 16.0统计分析软件进行数据处理,计量资料采用方差或Kruskal-Wallis H检验,相关性分析采用Spearman相关系数。结果 血浆sTREM-1水平脓毒症组高于SIRS组及对照组[分别为250.9 (195.8 ～ 354.3) ng/L、103.6(89.4～166.2)ng/L、33.6 (26.2 ～43.0) ng/L,P＜0.01],死亡组高于生存组[分别为360.5 (262.2 ～434.5)ng/L、204.1（175.0～269.6）ng/L,P＜0.01];脓毒症组患者血浆sTREM-1水平与APACHEⅡ评分呈正相关(r,=0.426,P=0.032);sTREM-1 ROC曲线下面积为0.935,高于PCT、CRP。结论 血浆sTREM-1水平对脓毒症早期诊断有一定意义,早期sTREM-1水平升高与不良预后相关。