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
投稿时间:2017-04-22  修订日期:2017-05-10  点此下载全文
引用本文:李智鑫,应利君,金烈洲,吕铁,孟东亮.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[J].医学研究杂志,2018,47(2):137-140
DOI: 10.11969/j.issn.1673-548X.2018.02.032
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作者单位E-mail
李智鑫 312000 绍兴市人民医院、浙江大学绍兴医院重症医学科  
应利君 312000 绍兴市人民医院、浙江大学绍兴医院重症医学科 yinglj6666@163.com 
金烈洲 312000 绍兴市人民医院、浙江大学绍兴医院重症医学科  
吕铁 312000 绍兴市人民医院、浙江大学绍兴医院重症医学科  
孟东亮 312000 绍兴市人民医院、浙江大学绍兴医院重症医学科  
基金项目:浙江省绍兴市公益性应用研究计划项目(2013B70077)
中文摘要: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。
中文关键词:肺泡灌洗液  可溶性髓系细胞触发受体-1  重症肺炎
 
Significance of Dynamic Monitoring of sTREM-1 in Bronchoalveolar Lavage Fluid for Prognosis of Patients with Severe Pneumonia
Abstract: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.
keywords:Alveolar lavage fluid  Soluble Triggering receptors expressed on myeloid cells-1  Severe pneumonia
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