利用ROC曲线分析sTREM-1、PCT和CRP对多发伤早期感染的诊断价值

目的利用ROC曲线分析血清可溶性髓样细胞触发受体-1（sTREM-1）、降钙素原（PCT）和C反应蛋白（CRP）对多发伤患者早期感染的诊断价值。方法测定57例ISS评分≥16分的多发伤患者血清sTREM-1、PCT和CRP含量,并与对照组进行比较,应用受试者工作特征曲线（ROC）进行分析。结果与对照组相比,多发伤早期未并发感染和并发感染的患者血清sTREM-1、PCT和CRP均呈不同程度升高（P均〈0.01）;与非感染组相比,并发感染患者血清sTREM-1和PCT仍呈不同程度升高（P均〈0.01）,而CRP在两组之间无显著差异（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;最佳阀值分别为8.96 ng/ml,8.29 ng/ml,67.95 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是严重多发伤患者早期感染较好的辅助诊断指标,其诊断性能明显优于PCT和CRP。

Diagnosis value of ROC Curve analysis on sTREM-1,PCT and CRP for patients with multipte injury early infection

Objective Discuss the value of using ROC Curve to analyze soluble triggering receptors expressed on myeloid cells-1（sTREM-1）,Procalcitonin（PCT） and C reactive protein（CRP） for the diagnosis of patients with multiple injury earyly infection.Methods Evaluate the serum sTREM-1,PCT and serum CRP level of the 57 patients with multiple injury whose ISS score≥16.Comparing with the control group,analyze the result by ROC method.Results Compare to the control group,the multiple injuries patients with early infection and that without early infection,their serum sTREM-1,PCT and CRP level increased（P〈0.01）.Compare to the patient without infection,the sTREM-1,PCT level of the patients with infection also increased（P〈0.01）,but the CRP level remained the same（P〈0.05）.The sTREM-1,PCT and CRP area under the ROC curve are 0.954,0.863 and 0.785;best threshold are 8.96 ng/ml,8.29 ng/ml,67.95 mg/L;sensitivity are 0.912,0.787,0.938;specifity are 0.894,0.845,0.513.Conclusion Serum sTREM-1 is a better diagnostic marker of early infection for severe multiple injury patients,whose diagnostic performance is significantly better than PCT and CRP.