共查询到20条相似文献,搜索用时 234 毫秒
1.
2.
3.
4.
5.
6.
7.
目的:分析肛周脓肿患者的严重程度与纤维蛋白原、D-二聚体间的相关性。方法:选择150例肛周脓肿患者,检测其纤维蛋白原(FIB)、D-二聚体检测水平,并分析肛周脓肿严重程度与FIB、D-二聚体的关系。结果:FIB与病情严重程度负相关(r=-0.147,P=0.046),而D-二聚体与病情严重程度正相关(r=0.810,P=0.007)。结论:肛周脓肿患者的FIB、D-2聚体水平与其病情严重程度相关,均可作为判断患者病情严重程度和预后指标之一。 相似文献
8.
9.
10.
11.
目的 探讨脓毒症患者血清可溶性髓系细胞表达的触发受体-1(sTREM-1)水平与疾病预后的关系.方法 采用前瞻性对照研究方法.选择2009年3月至12月天津医科大学第二医院重症监护病房(ICU)收治的50例脓毒症患者,按病情分为普通脓毒症组(28例)、严重脓毒症组(22例),按28 d转归分为生存组(34例)、死亡组(16例).于发病1、3、7 d检测血常规、血生化、血气分析、C-反应蛋白(CRP)、降钙素原(PCT),并进行急性生理学与慢性健康状况评分系统Ⅱ(APACHE Ⅱ)评分,采用酶联免疫吸附法(ELISA)检测血清sTREM-1浓度.对sTREM-1与APACHE Ⅱ评分、血白细胞计数(WBC)、CRP进行相关性分析,并进行Logistic回归分析.以同期30例健康体检者作为健康对照组.结果 50例脓毒症患者发病1 d血清sTREM-1浓度(ng/L)明显高于健康对照组(52.80±9.30比23.29±6.22,P<0.01).严重脓毒症组发病1、3、7 d血清sTREM-1浓度(ng/L:58.25±10.59、65.75±13.57、50.18±21.73)均明显高于普通脓毒症组(48.55±5.20、42.85±8.54、34.02±12.86,P<0.05或P<0.01).生存组发病1、3、7 d sTREM-1浓度(ng/L)逐渐下降(53.07±10.47、45.04±9.89、32.84±8.42),7 d时接近正常水平;死亡组发病1、3、7 dsTREM-1浓度(ng/L)逐渐上升(52.27±6.42、69.67±12:12.83、75.705±10.55),3 d、7 d时明显高于生存组(均P<0.01).血清sTREM-1浓度与APACHE Ⅱ评分呈显著正相关(r=0.657,P<0.01),与血WBC无相关性(r=0.023,P>0.05),与CRP有一定相关性(r=0.150,P<0.10).Logistic回归分析显示sTREM-1[相对比值比(OR)=0.893,P=0.000]、APACHE Ⅱ评分(OR=0.771,P=0.000)为影响预后的死亡危险因素,受试者工作特征曲线下面积(AUC)分别为0.868、0.930;以sTREM-1为50 ng/L评价预后的敏感性为81.1%,特异性为74.5%APACHE Ⅱ评分20分的敏感性为83.8%,特异性为86.3%.结论 在脓毒症发病早期血清sTREM-1浓度升高,其变化趋势可能与疾病严重程度有关,与APACHE Ⅱ评分有显著的相关性,是影响预后的死亡危险因素之一.Abstract: Objective To approach the relationship between the contents of soluble form of triggering receptor expressed on myeloid cells-1 (sTREM-1) and prognosis in patients with sepsis. Methods Using prospective, control study design, a total of 50 patients with sepsis who were admitted in intensive care unit (ICU) of the Second Hospital of Tianjin Medical University from March to December in the year of 2009 were enrolled. Firstly, the patients were divided into sepsis (n=28) and severe sepsis (n=22) groups according to the patients' condition. Then the patients were divided into survival group (n = 34) and death group (n = 16)according to the clinical outcome at 28 days after onset of sepsis. Clinical and laboratory data including blood routine tests, blood chemistry, blood gas analysis, C-reactive protein (CRP) and procalcitonin (PCT) were collected on the 1st, 3rd and 7th day after onset. Acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ ) score was determined. sTREM-1 levels were determined using enzyme linked immunosorbent assay (ELISA) method. Correlation analysis of the sTREM-1, APACHE I score, white blood cell count (WBC) and CRP, using Logistic regression analysis. A total of 30 healthy persons were enrolled into the control group. Results The sTREM-1 levels (ng/L) in 50 septic patients on the 1st day were higher than those of the healthy persons (52. 80±9. 30 vs. 23. 29±6. 22, P<0. 01). The sTREM-1 levels (ng/L) in severe sepsis group on the 1st, 3rd and 7th day (58. 25±10. 59, 65. 75±13. 57, 50.18±21. 73) were higher than those of the sepsis group (48.55±5.20, 42.85±8.54, 34.02±12.86, P<0.05 or P<0.01). The sTREM-1 levels (ng/L) of the survival group on the 1st, 3rd and 7th day (53. 07± 10. 47, 45. 04±9. 89,32. 84 ±8. 42) were decreased with the progression of the ailment. The sTREM-1 levels did not differ significantly between the control group and survival group on the 7th day (P>0. 05). The sTREM-1 levels (ng/L) in the death group on the 1st, 3rd and 7th day were increased with the progression of the ailment (52.27±6.42, 69.67±12.83, 75. 70± 10. 55), and the level was significantly higher than that in survival group on the 3rd and 7th day (both P<0. 01). The contents of sTREM-1 were positive correlated with APACHE Ⅱ score (r= 0.657, P<0. 01), but not correlated with WBC (r= 0.023, P>0. 05), whilesomewhat correlated with CRP (r=0. 150, P<0.10). Logistic regression analysis showed that sTREM-1 [odds ratio (OR) = 0. 893,P = 0. 000] and APACHE I score (OR = 0.771, P = 0.000) might be potential prognostic factors for septic patients. The area under the receiver operator characteristic curve was 0. 868 and 0.930. The sensitivity of prognostic evaluation was 81.1% and specificity was 74.5% with sTREM-1 50 ng/L, and the sensitivity was 83. 8% and specificity was 86. 3% with APACHE Ⅱ score 20 to estimate the outcome. Conclusion The serum sTREM-1 are elevated at early stage in sepsis patients. It can reflect the severity of the condition. The sTREM-1 level, which might be considered as a potential prognostic factor for septic patients, is significantly correlated with APACHE Ⅱ score. 相似文献
12.
目的探讨小剂量糖皮质激素对小儿脓毒症血清可溶性髓系细胞触发受体1(s TREM-1)、降钙素原(PCT)、CD_(64)的影响。方法选取66例脓毒症患儿,依据随机数字表法分成2组各33例。对照组予原发病和(退热等)对症治疗,予以脓毒症集束化(抗生素、强化胰岛素、营养支持等)治疗,研究组在上述基础上再予小剂量注射用甲泼尼龙琥珀酸钠静点,治疗7 d。检测外周血T淋巴细胞、炎性指标(PCT、CRP、IL-8)和sTREM-1、sICAM-1及sVCAM-1水平。评估PCIS及APACHEⅡ评分,比较治疗效果。结果与治疗前比较,2组CD_3~+、CD_4~+及CD_8~+显著升高(P0.01),CD_(64)+降低(P0.01),PCT、CRP、IL-8显著降低(P0.01),sTREM-1、sICAM-1、sVCAM-1显著降低(P0.01),PCIS评分显著升高(P0.05),APACHEⅡ评分显著降低(P0.05);与对照组比较,研究组CD_3~+、CD_4~+及CD_8~+显著较高(P0.01),CD_(64)+显著较低(P0.01),PCT、CRP、IL-8显著较低(P0.01),sTREM-1、sICAM-1、sVCAM-1显著较低(P0.01),PCIS评分显著较高(P0.05),APACHEⅡ评分显著较低(P0.05),总有效率显著较高(P0.05)。结论小剂量糖皮质激素能有效降低脓毒症患儿血清sTREM-1、PCT、CD_(64)~+水平。 相似文献
13.
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 总被引:1,自引:1,他引:1
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。 相似文献
14.
目的:探讨血清可溶性白细胞分化抗原14亚型(sCD14-ST,presepsin)对脓毒症早期诊断价值及预后意义。方法采用前瞻性研究方法,于2014年1月至2015年6月收集患者80例,根据脓毒症诊断标准分为脓毒症组50例、非感染性系统性炎症反应综合征组(systemic inflammatory response syndrome,SIRS)30例,同期选择25例健康查体者作为对照组;根据28 d 预后将脓毒症组分为生存组35例和死亡组15例。入院第1、3、7天晨时取血,动态观察血清presepsin、降钙素原(procalciton,PCT)、可溶性髓系细胞表达的触发受体-1(soluble myeloid cells expressing triggering receptor-1,sTREM-1)、C 反应蛋白(C-reactive protein,CRP)和白介素-6(interleukin 6,IL-6)水平。结果(1)脓毒症组患者入院第1 天血清 presepsin 高于 SIRS 组及对照组[912.0(563.5,1514.8)pg/mLvs.462.0(334.0,556.0)pg/mL vs.120.0(70.2,320.1)pg/mL,P <0.05];(2)第1 天 presepsin 的 ROC 曲线下面积(AUC)高于 PCT、sTREM-1、CRP、IL-6,当其截断值为672.5 pg/mL 时,其诊断脓毒症的敏感度为80%,特异度为96.7%,presepsin、PCT 和 sTREM-1三个指标联测明显诊断效能提高;(3)生存组随着病情好转,血清 presepsin、PCT、sTREM-1和 IL-6逐渐下降至正常水平,均低于同时点死亡组(P <0.05),上述指标在死亡组无显著下降趋势(P >0.05);(4)presepsin 预测脓毒症结局的 AUC 高于 PCT、sTREM-1, presepsin、PCT 和 sTREM-1三个指标联测明显提高预后判断能力。结论血清 presepsin 是脓毒症早期诊断的一个较好指标,其敏感度和特异度高于其他炎性指标,与疾病严重程度相关,与 PCT和 sTREM-1联测能够提高脓毒症早期诊断和和死亡风险预测。 相似文献
15.
目的:探讨乌司他丁对脓毒症患者可溶性髓样细胞触发受体-1 (sTREM-1)表达的影响.方法:选择60例确诊脓毒症的患者随机分为乌司他丁治疗组和常规治疗对照组,各30例.乌司他丁治疗组在常规治疗的基础上,加用乌司他丁20万单位/次静脉注射,2次/日连续10 d,分别于治疗前,治疗前第3、7和10日时取两组患者静脉血,采用ELISA法检测血清sTREM-1浓度,采用免疫比浊法检测CRP浓度.观察两组患者APACHEⅢ评分变化,并记录治疗后3、7、10和28 d时两组患者生存或死亡情况.检测30例健康志愿者的血清sTREM-1和CRP浓度作为正常对照组.结果:治疗前两组血清sTREM-1和CRP浓度显著高于健康对照组 (P<0.05),但两组患者血清sTREM-1和CRP浓度比较差异无统计学意义(P>0.05).治疗3、7、10 d两组血清sTREM-1和CRP浓度较治疗前逐步下降(P<0.05).乌司他丁治疗组较常规治疗对照组血清sTREM-I和CRP浓度下降更显著(P<0.05).APACHEⅢ评分降低更明显(P<0.05).结论:乌司他丁可降低脓毒症患者血清sTREM-1和CRP水平,减轻脓毒症炎症反应强度,减少MODS的发生,从而缓解脓毒症临床症状,改善预后. 相似文献
16.
BACKGROUND:
Biomarkers may be helpful in risk stratification and prediction of mortality in septic patients. This study aimed to investigate the diagnostic role of soluble triggering receptor expressed on myeloid cell-1(sTREM-1), procalcitonin (PCT), C-reactive protein (CRP) and other inflammatory markers in patients with sepsis.METHODS:
A total of 56 patients with systemic inflammation response syndrome (SIRS) who had been admitted to the ICU department of the Second Hospital of Tianjin Medical University between May 2009 and July 2010 were enrolled. They were divided into a sepsis group (n=32) and a SIRS group (n=24). Twenty-five non-SIRS patients served as controls. The sepsis group was sub-divided into a survival group and a death group according to 28-day prognosis. The values of sTREM-1, PCT, CRP, white blood cell (WBC), and neutrophil count percentage (N) were measured. Acute physiology and chronic health evaluation II (APACHE II) score were determined within 24 hours. The correlation between sTREM-1 and APACHE II score was analyzed. Quantitative data were analyzed by the F test or the Kruskal-Wallis test.RESULTS:
The plasma level of sTREM-1 in the sepsis group was significantly higher than that in the SIRS group and control group. The plasma level of sTREM-1 in the non-survival group was significantly higher than that in the survival group. In the sepsis group, the plasma sTREM-1 level was positively correlated with APACHE II score (r=0.426, P= 0.032). The area under the ROC curve of sTREM-1 was 0.935, larger than that of PCT and CRP.CONCLUSION:
Plasma sTREM-1 is useful in the diagnosis of sepsis at early stage. The increased level of sTREM-1 during the first 24 hours may be correlated with poor outcome of patients with sepsis.KEY WORDS: Sepsis, sTREM-1, Acute physiology and chronic health evaluation II score, Enzyme-linked immunosorbent assay, Procalcitonin, C-reactive protein 相似文献17.
目的:探讨降钙素原(PCT)、血小板(PLT)监测对脓毒症患者预后判断的临床价值。方法:90例脓毒血症患者分别在人ICU第1、3、5、7天进行PCT和PLT检测,根据预后情况分为生存组(n=60例)和死亡组(n=30),比较两组间PCT、PIJT与APACHEⅡ评分的关系。结果:与生存组比较,死亡组PCT明显增高,且持续保持较高水平(P〈O.05);PLT明显下降,且呈进行性下降趋势(P〈0.05)。PCT、PIJT水平和APACHEⅡ评分明显相关(P〈0.05)。结论:PCT、PLT对判断脓毒症患者预后有一定的临床价值。 相似文献
18.
目的 研究前白蛋白(PA)、C-反应蛋白(CRP)和D-二聚体(DD)的动态变化与肺炎并感染性休克患者病情严重度及预后的关系.方法 测定48例肺炎并感染性休克患者入院第1、3、5天以及出院或死亡前最后一次的PA、CRP、DD、APACHEⅡ评分,按预后将患者分为死亡组及存活组进行动态观察,并对APACHEⅡ评分与PA、CRP、DD水平动态变化进行相关性分析.结果死亡组与存活组入院后第1天PA[(164.33±23.32)、(163.51±32.54)mg/L,t=2.315,P>0.05]、CRP[(93.25±27.67)、(94.37±30.81)mg/L,t=2.013,P>0.05]和DD[(917.60±17.09)、(918.07±23.78)μg/L,t=2.511,P>0.05]比较差异均无统计学意义,死亡组第3、5天和最后一次PA水平明显低于存活组[(118.4±34.7)、(91.7±12.5)、(69.8±21.4)mg/L与(165.3±12.8)、(172.6±11.3)、(189.1±32.6)mg/L,t值分别为2.422、2.557、2.906,P均<0.05],CRP水平明显高于存活组[(109.5±30.1)、(121.2±31.7)、(133.6±35.1)mg/L与(83.0±45.2)、(67.6±21.6)、(13.1±3.3)mg/L,t值分别为2.061、2.843、3.519,P均<0.01],DD水平也明显高于存活组[(1138.0±22.8)、(1312.6±2 8.5)、(1830.3±36.2)μg/L与(860.7±38.7)、(651.8±25.6)、(490.6±13.4)μg/L,t值分别为2.576、2.823、3.371,P均<0.01],PA与APACHEⅡ评分呈负相关(r=-0.631,P<0.01),CRP及DD与APACHEⅡ评分呈正相关(r值分别为0.687、0.651,P<0.01).结论 PA持续低水平、CRP和DD持续高水平提示病情危重,所以联合动态观察PA、CRP和DD对评估肺炎并感染性休克病情严重程度及预后有重要的临床意义. 相似文献
19.
【目的】探讨降钙素原(PCT)的检测在脓毒症急性肾损伤(AKI)患者预后评估的临床价值。【方法】选择本院收治的脓毒症致AKI患者63例作为A组,同期收治的69例脓毒症无AKI作为B组,比较两组患者肾功能指标、PCT以及APACHEⅡ评分,并分析AKI患者PCT水平与APACHEⅡ评分及与患者死亡之间的关系。【结果】A组患者肌酐(SCr)、血尿素氮(BUN),PCT以及APACHEⅡ评分均显著高于B组,且差异具有显著性(P〈0.05);A组PCT水平与SCr、BUN以及APACHEⅡ评分均呈显著正相关关系(P〈0.05);B组PCT水平与SCr、BUN以及APACHEⅡ评分无明显相关性(P〉0.05);不同APACHEⅡ评分患者血清PCT水平差异具有显著性(P〈0.05),随着APACHEⅡ评分的增高,患者PCT水平显著升高;应用ROC曲线分析PCT对AKI患者死亡预测作用,ROC曲线下面积为0.829,95%可信区间为(0.719~0.939)(P〈0.05)。【结论】PCT对于脓毒症致AKI患者具有着较高的诊断和预测价值,能够较好预测患者的病情和预后。 相似文献
20.
目的分析血清淀粉酶样蛋白A(SAA)、可溶性髓系细胞触发受体1(sTREM-1)、降钙素原(PCT)联合检测在新生儿宫内感染性肺炎早期诊断中的应用价值。方法选取本院118例新生儿,其中无宫内感染高危因素+未发生感染32例(对照组),有宫内感染高危因素+未发生感染40例(A组),有宫内感染高危因素+宫内感染性肺炎46例(B组),检测各组脐血SAA、sTREM-1、PCT水平,以受试者工作特征(ROC)曲线分析SAA、sTREM-1、PCT联合检测诊断价值。结果 B组SAA、sTREM-1、PCT水平明显高于对照组与A组,差异具有统计学意义(P<0.05)。对照组与A组SAA、sTREM-1、PCT水平比较差异无统计学意义(P>0.05)。ROC曲线分析显示,SAA诊断敏感度71.2%,特异度88.4%;sTREM-1诊断敏感度65.7%,特异度84.2%;PCT诊断敏感度72.6%,特异度90.3%;三者联合诊断敏感度85.7%,特异度94.5%。结论宫内感染性肺炎新生儿脐血SAA、sTREM-1及PCT表达水平呈明显升高趋势,三者联合对新生儿宫内感染性肺炎具有较高早期诊断价值。 相似文献