动态监测支气管肺泡灌洗液中sTREM-1对重症肺炎患者病情及预后评价的意义

目的 探讨重症肺炎患者支气管肺泡灌洗液中可溶性髓系细胞触发受体-1（sTREM-1）的表达及对重症肺炎患者病情及预后评价的意义。方法 将笔者医院重症监护室收治的60例重症肺炎患者作为病例组，重症医学科健康医护人员20例作为对照组，检测重症肺炎患者入科后0、1、3、7天支气管肺泡灌洗液（BALF） sTREM-1、血清sTREM-1、前降钙素（PCT）和C反应蛋白（CRP）的水平，而对照组只检测一次上述指标，评价上述指标对重症肺炎患者预后的预测价值。结果 重症肺炎组患者灌洗液sTREM-1、血清sTREM-1、PCT和CRP的浓度明显高于对照组（P<0.05）。死亡组患者肺泡灌洗液sTREM-1、血清sTREM-1、PCT和CRP的浓度明显高于存活组（P<0.05），肺泡灌洗液sTREM-1判断重症肺炎预后的敏感度为82.5%，特异性为81.0%，ROC曲线下面积为0.845，明显优于血清sTREM-1、PCT及CRP （P<0.05）。结论 肺泡灌洗液sTREM-1对重症肺炎患者预后的判断有重要价值。

Significance of Dynamic Monitoring of sTREM-1 in Bronchoalveolar Lavage Fluid for Prognosis of Patients with Severe Pneumonia

Objective To study the expression sTREM-1 in bronchoalveolar lavage fluid (BALF) in patients with severe pneumonia and its significance in severity and prognosis of severe pneumonia.Methods Sixty patients with severe pneumonia were enrolled in the intensive care unit of our hospital as the case group. Twenty patients in the intensive care unit were taken as the control group. The levels of serum sTREM-1, sTREM-1, procalcitonin (PCT) and C-reactive protein (CRP) in bronchoalveolar lavage fluid were measured at 0, 1 day, 3 days and 7 days. While the control group were only detected once the above indicators to evaluate the prognosis of patients with severe pneumonia prognostic value.Results The concentrations of sTREM-1, sTREM-1, PCT and CRP in the severe pneumonia group were significantly higher than those in the control group (P<0.05). The concentrations of sTREM-1, sTREM-1, PCT and CRP in the alveolar lavage fluid of the death group were significantly higher than those of the survival group (P<0.05). The sensitivity and specificity of bronchoalveolar lavage fluid sTREM-1 in predicting the prognosis of severe pneumonia were 82.5% and 81.0%, respectively. The area under ROC curve was 0.845, which was significantly better than that of serum sTREM-1, PCT and CRP (P<0.05).Conclusion sTREM-1 in bronchoalveolar lavage fluid is of great value in prognosis of patients with severe pneumonia.