烧伤感染脓毒症患者sTREM-1与Presepsin和GPBB水平

目的探究烧伤感染脓毒症患者可溶性髓细胞表达触发受体-1(sTREM-1)、sCD14亚型(Presepsin)、糖原磷酸化酶同工酶BB(GPBB)的相关性。方法选取2019年4月-2020年4月唐山市工人医院收治的烧伤患者168例,按烧伤后感染程度分为局部感染组、脓毒症组各84例,另选取于医院健康体检的健康志愿者84名为对照组。使用酶联免疫吸附法检测三组人群补体C3(C3)、C-反应蛋白(CRP)、凝溶胶蛋白(GSN)、降钙素原(PCT)水平,使用散射比浊法检测组织因子(TF)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平,采用免疫透射比浊法检测sTREM-1、Presepsin、GPBB水平。结果脓毒症组C3、CRP、PCT水平分别为(805.25±100.23)μg/ml、(135.26±45.86)mg/L、(0.71±0.94)mg/L,高于局部感染组(456.89±60.15)μg/ml、(63.25±20.15)mg/L、(0.49±0.25)mg/L及对照组,GSN水平为(106.44±18.36)mg/L低于局部感染组(168.26±48.12)及对照组(P<0.05);脓毒症组TF、TNF-α、IL-6水平分别为(31.27±5.61)ng/ml、(98.25±29.67)pg/ml、(254.32±24.65)pg/ml高于局部感染组(21.56±3.69)ng/ml、(61.58±20.15)ng/ml、(150.25±10.15)pg/ml及对照组(P<0.05);脓毒症组sTREM-1、Presepsin、GPBB水平分别为(65.25±12.15)pg/ml、(954.58±129.05)ng/ml、(23.15±7.15)ng/ml高于局部感染组(48.55±5.23)pg/ml、(356.58±110.26)pg/ml、(12.26±5.63)ng/ml及对照组(P<0.05)。在烧伤感染脓毒症中,sTREM-1与Presepsin呈正相关(r=0.225,P=0.039);sTREM-1与GPBB水平呈正相关(r=0.221,P=0.042);Presepsin与GPBB水平呈正相关(r=0.273,P=0.011)。结论 sTREM-1、Presepsin、GPBB水平在烧伤感染脓毒症患者中出现异常升高,且与烧伤感染脓毒症有一定的相关性。

sTREM-1 and presepsin and GPBB in burn patients infected with sepsis

OBJECTIVE To investigate the correlation between the expression of soluble myeloid cells expressing triggering receptor-1(sTREM-1), sCD14 isoform(presepsin), and glycogen phosphorylase isozyme BB(gpbb) in burn patients infected with sepsis. METHODS A total of 168 burn patients admitted to Tangshan workers′ hospital from Apr. 2019 to Apr. 2020 were selected and divided into local infection group and sepsis group according to the degree of burning, with 84 cases in each group. Another 84 healthy volunteers who received a physical examination in the hospital were selected as control group. The levels of complement C3(C3), C-reactive protein(CRP), gelsolin(GSN) and procalcitonin(PCT) of patients in the three groups were detected by enzyme-linked immunosorbent assay. The levels of tissue factor(TF), tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6) were detected by nephelometry. The levels of sTREM-1, presepsin and gpbb were detected by immunoturbidimetry. RESULTS The levels of C3, CRP and PCT of patients in sepsis group were(805.25±100.23)μg/ml,(135.26±45.86)mg/L,(0.71±0.94)mg/L respectively, significantly higher than those in local infection group(456.89±60.15)μg/ml,(63.25±20.15)mg/L, and(0.49±0.25)mg/L, respectively and control group(P<0.05), the levels of GSN in sepsis group were(106.44±18.36)mg/L, significantly lower than those in local infection group(168.26±48.12) and control group(P<0.05). The levels of TF, TNF-α and IL-6 in sepsis group were(31.27±5.61)ng/ml,(98.25±29.67)pg/ml, and(254.32±24.65)pg/ml, respectively, significantly higher than those in local infection group(21.56±3.69)ng/ml,(61.58±20.15)ng/ml, and 150.25±10.15 pg/ml, respectively and control group(P<0.05);the levels of sTREM-1, presepsin and gpbb in sepsis group were(65.25±12.15)pg/ml,(954.58±129.05)ng/ml, and(23.15±7.15)pg/ml, respectively, significantly higher than those in the local infection group(48.55±5.23)pg/ml,(356.58±110.26)pg/ml, and(12.26±5.63)ng/ml, respectively and control group(P<0.05). In burn patients infected with sepsis, the STREM-1 was positively correlated with presepsin(r=0.225, P=0.039);sTREM-1 was positively correlated with gpbb(r=0.221, P=0.042);presepsin was positively correlated with gpbb(r=0.273, P=0.011). CONCLUSION The levels of sTREM-1, presepsin and GPBB were abnormally increased in burn patients infected with sepsis, and had a certain correlation with burn infection sepsis.