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血浆可溶性髓样细胞触发受体-1水平在脓毒症监测中的意义

王洪霞,刘健   

  1. 天津医科大学第二医院
  • 收稿日期:2011-02-18 修回日期:2011-04-12 出版日期:2011-08-15 发布日期:2011-08-15
  • 通讯作者: 王洪霞

Clinical Significance of sTREM (soluble triggering receptor expressed on myeloid cells)-l in Patiens with Sepsis

  • Received:2011-02-18 Revised:2011-04-12 Published:2011-08-15 Online:2011-08-15
  • Contact: Wang Hongxia

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摘要： 目的：探讨血浆可溶性髓样细胞触发受体-1(sTREM-1) 在脓毒症临床监测中的意义。方法：选择脓毒症患者32例为病例组，根据28天预后情况分为生存组（n=21）和死亡组（n=11）。以同期健康体检者25例为对照组。病例组入院24小时内检测血常规，测定血清C反应蛋白(CRP)，留取血浆，计算急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分。比较病例组与对照组、生存组与死亡组间临床参数异同。酶联免疫吸附法（ELISA）检测sTREM-1水平。结果：血浆sTREM-1水平病例组高于对照组（P<0.01），死亡组高于生存组(P<0.01)。APACHEⅡ评分死亡组高于生存组（t=2.657, P<0.05），病例组血浆sTREM-1水平与APACHEⅡ评分呈显著正相关(r=0.426，P=0.032)。病例组CRP、白细胞计数(WBC)、中性粒细胞百分率(N)均高于对照组（P均<0.05）, 死亡组与生存组间无差异（P均>0.05）。结论: 血浆sTREM-1水平是脓毒症临床监测的有用指标，患者早期sTREM-1水平升高与不良预后相关。

关键词: 脓毒症, 髓样细胞触发受体-1, 可溶性, 预后, APACHEⅡ评分

Abstract: Objective: To investigate the clinical significance of sTREM (soluble triggering receptor expressed on myeloid cells)-1 in patients with sepsis. Methods: Using prospective, randomly control study design, 32 patients suffered from sepsis between May 2009 and July 2010 were collected．They were divided into survival group and non-survival group according to 28-day prognosis. 25 health volunteers were controls. Clinical date were determined and APACHEⅡscore were recorded in 24 hours. The differences between them were compared. The level of sTREM-1 were measured by enzyme linked immunoabsorbant assay(ELISA). Results: The level of sTREM-1 was significantly higher in sepsis patients than that of controls[250.9(195.8,354.3)ng/L vs 25.7(21.5,53.3)ng/L, P<0.01]. It was significantly higher in non-survivors(n=11) than that of survivors(n=21) [360.5(262.2,434.5)ng/L vs 204.1(175.0,269.6) ng/L，P<0.01]. APACHEⅡscore was significantly higher in non-survivors(n=11) than that of survivors (t=2.657, P<0.05). The levels of sTREM-1 showed obviously positive correlation with APACHEⅡscore(r=0.426, P=0.032).There were no different between non-survivors and survivors in C-reaction protein(CRP), white blood cell(WBC) and neutrophil count percentage(N), but they were higher in sepsis group than that of in controrls. Conclusion: Plasma level of sTREM-1 is a useful index in monitoring during sepsis.The increase of sTREM-1 was associated with pour prognosis .

Key words: sepsis, triggering receptor expressed on myeloid cells-1, soluble, prognosis, APACHEⅡscore