可溶性髓系细胞触发受体-1在细菌性胸腔积液诊断中的价值

目的检测细菌性胸腔积液患者胸水中可溶性髓系细胞触发受体1（sTREM1）的水平，研究sTREM．1对诊断细菌性胸腔积液的意义。方法应用定量酶联免疫吸附法（ELISA）检测30例细菌性胸腔积液患者、33例恶性胸腔积液患者、31例结核性胸腔积液患者及28例漏出液胸水中sTREM1，免疫浊度法检测其胸水c反应蛋白（CRP）的水平。应用受试者工作特征ROC曲线研究sTREM1的诊断效能。结果细菌性胸腔积液患者sTREM1水平为（1255．2±248．6）ng／L]，较恶性胸腔积液组（125．6±22．4）ng／L]、结核性胸腔积液组（184．5±36．5）ng／L]及漏出液组（92．5±20．8）ng／L]显著升高（P〈0．05），根据ROC曲线，取sTREM-1〉425ng／L为临界值，其曲线下面积为0．953，诊断细菌性胸腔积液的灵敏度、特异度、准确率、阳性预测值和阴性预测值分别为93．3％、90．3％、91．9％、93．2％和93．3％，诊断效能高。结论测定胸水sTREM1水平有助于区分细菌性胸腔积液与其它原因的胸腔积液。

The value of soluble triggering receptor expressed on myeloid cells-1 in the diagnosis of bacterial pleural effusion

Objective To investigate the value of soluble triggering receptor expressed on myeloid cells-1(sTREM-1) in the diagnosis of bacterial pleural effusion. Methods The levels of sTREM-1 in pleural effusion were determined in 30 patients with bacterial pleural effusion, 33 patients with malignant pleural effusion,31 patients with tuberculous pleural effusion and 28 patients with transudate by quantitative ELISA assay. The levels of CRP in pleural effusion were assayed using immunonephelometry method. The diagnostic value was assessed by receiver operating characteristic ROC curve analysis. Results The levels of sTREM-1［(1255.2±248.6)ng/L］ in bacterial pleural effusion were significantly higher than those in malignant ［（125.6±22.4）ng/L］, tuberculous［（184.5±36.5）ng/L］ and transudate groups［（92.5±20.8）ng/L］ (P＜0.05). For ROC curve, when the cut off value of sTREM-1 was set at 425 ng/L, the sensitivity , specificity ,accuracy, positive predictive value and negative value was 93.3%,90.3%,91.9%,93.2% and 93.3%, respectively. Conclusions Detection of sTREM-1 in pleural effusion is helpful to differentiate pleural effusion of bacterial origin from those with other etiologies.