可溶性髓样细胞触发受体-1对严重多发伤患者继发感染早期诊断价值探讨

目的 探讨可溶性髓样细胞触发受体-1(sTREM-1)对严重多发伤患者继发感染的早期诊断价值.方法 测定57例损伤严重度评分不低于16分的多发伤患者血清sTREM-1、降钙素原(PCT)和C反应蛋白(CRP)含量,并与健康对照组进行比较,应用ROC曲线进行分析.结果 与健康对照组比较,多发伤未继发感染和继发感染患者血清sTREM-1、PCT和CRP水平升高(P＜0.05);继发感染组血清sTREM-1和PCT水平高于非感染组(P＜0.05),CRP水平比较差异无统计学意义(P＞0.05).sTREM-1、PCT和CRP的ROC曲线下面积分别为0.954,0.863和0.785;最佳阈值分别为8.79、8.16 ng/mL和69.47 mg/L,灵敏度分别为0.912、0.787和0.938,特异度分别为0.894、0.845和0.513.结论 血清sTREM-1是早期诊断严重多发伤患者继发感染的较好指标,其诊断效能优于PCT和CRP.

Clinical value of soluble triggering receptors expressed on myeloid cells-1 for the early diagnosis of infection in patients with severe multiple injury

Objective To investigate the clinical value of soluble triggering receptors expressed on myeloid cells-1(sTREM-1) for the early diagnosis of infection in patients with severe multiple injury.Methods Serum sTREM-1,PCT and CRP level in 57 patients with severe multiple injury with ISS≥16 and healthy controls were detected and ROC analysis was performed.Results Compared with the control group,serum sTREM-1,PCT and CRP level in multiple injury with secondary infection and without secondary infection groups were increased(P<0.05).Compared with patients without infection,serum sTREM-1 and PCT levels in patients with infection were increased(P<0.05),but there was no significant difference of serum CRP level(P>0.05).The area under ROC curve of sTREM-1,PCT and CRP were 0.954,0.863 and 0.785,with best threshold of 8.79,8.16 ng/mL and 69.47 mg/L,sensitivity of 0.912,0.787,0.938 and specificity of 0.894,0.845 and 0.513.Conclusion Serum sTREM-1 could be a fine early diagnostic marker of infection in patients with severe multiple injury,with better diagnostic performance than PCT and CRP.