sTREM-1和Ang-2及PCT表达水平与脓毒症患者预后的相关性

Analysis of correlation between sTREM-1,Ang-2 and PCT and prognosis of patients with sepsis

目的分析可溶性髓样细胞触发受体-1(sTREM-1)、血管生成素2(Ang-2)、降钙素原(PCT)水平变化与脓毒症患者预后的相关性。方法收集2018年1月-2020年7月于铜川市人民医院接受治疗的脓毒症患者180例,检测其血清s TREM-1、Ang-2、PCT水平,随访30 d,根据随访结果将患者分为死亡组(n=57)和存活组(n=123),记录患者生存情况,比较不同预后患者一般资料、急性生理学及慢性健康状况评分系统(APACHEⅡ)评分及血清sTREM-1、Ang-2、PCT水平,分析血清sTREM-1、Ang-2、PCT水平与APACHEⅡ评分及预后的相关性,采用受试者工作特征曲线(ROC)评估血清sTREM-1、Ang-2、PCT对预后的预测价值。结果死亡组患者血清sTREM-1、Ang-2、PCT水平及APACHEⅡ评分均高于存活组,差异有统计学意义(P<0.05)。脓毒症患者血清sTREM-1、Ang-2、PCT水平与APACHEⅡ评分均呈显著正相关(r=0.335、0.254、0.363,P<0.05),与预后均呈显著正相关(r=0.493、0.527、0.565,P<0.05)。Logistics回归分析结果显示,血清sTREM-1>12.09μg/L、Ang-2>11.69μg/L、PCT>15.79μg/L均为影响脓毒症患者预后的危险因素(P<0.05)。ROC曲线分析结果显示,血清sTREM-1、Ang-2、PCT联合检测预测脓毒症患者30 d病死率的曲线下面积(AUC)值高于各指标单一检测(0.951 vs.0.810、0.841、0.828),差异有统计学意义(P<0.05)。结论脓毒症患者血清sTREM-1、Ang-2、PCT水平与病情严重程度和预后密切相关,对治疗后30 d死亡率有一定的预测价值,且联合检测可提高预测准确性。

Objective To analyze the correlation between changes of levels of soluble triggering receptor expressed on myeloid cells-1(s TREM-1),angiopoietin 2(Ang-2)and procalcitonin(PCT)and prognosis of patients with sepsis.Methods A total of 180 patients with sepsis treated in Tongchuan People’s Hospital from January 2018 to July 2020 were enrolled.The levels of serum sTREM-1,Ang-2 and PCT were detected.At 30 d of follow-up,the patients were divided into death group(n=57)and survival group(n=123)according to the follow-up results,and the survival status of patients was recorded.The general data,acute physiology and chronic health evaluation scoring systemⅡ(APACHEⅡ)score and levels of serum sTREM-1,Ang-2 and PCT were compared among patients with different prognosis.Correlation between levels of serum sTREM-1,Ang-2 and PCT and APACHEⅡscore and prognosis was analyzed.The predictive value of serum sTREM-1,Ang-2 and PCT on prognosis was assessed by receiver operator characteristic curve(ROC).Results The levels of serum sTREM-1,Ang-2 and PCT and APACHEⅡscore in death group were higher than those in survival group(P<0.05).The levels of serum s TREM-1,Ang-2 and PCT of patients with sepsis were significantly positively correlated with APACHEⅡscore(r=0.335,0.254,0.363,P<0.05),and were significantly correlated with prognosis(r=0.493,0.527,0.565,P<0.05).Logistics regression analysis showed that the levels of serum sTREM-1>12.09μg/L,Ang-2>11.69μg/L and PCT>5.79μg/L were all risk factors affecting the prognosis of patients with sepsis(P<0.05).ROC curve analysis showed that the area under curve(AUC)value of combined detection of serum sTREM-1,Ang-2 and PCT in predicting 30 d mortality rate of patients with sepsis was higher than that of single serum detection(0.951 vs.0.810,0.841,0.828,P<0.05).Conclusion Serum levels of s TREM-1,Ang-2 and PCT of patients with sepsis were closely related to the disease severity and prognosis,and had certain predictive value on mortality rate at 30 d after treatment,and combined detection could improve the predictive accuracy.