多发伤患者外周血可溶性髓系细胞触发受体-1的表达与临床意义

Expression of soluble human triggering receptors on myeloid cell-1 in patients with multiple trauma and its clinical significance

目的探讨多发伤患者外周血中可溶性髓系细胞触发受体-1（sTREM-1）蛋白水平的表达及其临床意义。方法将2007年10月至2008年1月收治的52例严重多发伤患者[创伤严重程度评分（ISS）≥16]作为多发伤组，7名健康志愿者作为对照组，检测外周血sTREM-1、肿瘤坏死因子（TNF—α）和C反应蛋白（CRP）的表达，并进行统计学处理，分析其临床意义。结果多发伤组外周血sTREM-1水平较对照组明显升高（P〈0．001）；ISSI〉25患者sTREM-1明显高于16≤ISS〈25患者（P〈0．05）。多发伤患者外周血sTREM-1和TNF-仪表达有相关性（r=0．845，P〈0．05），与CRP表达水平无相关性（r=0．426，P〉0．05）。脓毒症患者外周血sTREM-1水平高于非脓毒症患者（P〈0．05）。结论sTREM．1水平与ISS及患者是否发生脓毒症相关，提示TREM-1可能在多发伤患者发生脓毒症中起重要作用。

Objective To investigate the expression profile of human soluble Triggering receptor on myeloid cell-1 （ sTREM-1 ） in patients with multiple trauma and determine its clinical significance. Methods Peripheral blood of 52 patients admitted to the hospital from October 2007 to January 2008 with multiple traumas with injury severity score （ISS） ≥ 16 and 7 healthy volunteers were obtained, and sera samples were isolated, sTREM-1 was determined by semi-quantitative immunoblot technique. TNF-α and C-reactive protein （CRP） were determined by ELISA. Results sTREM-1 of patients with multiple traumas was significantly increased as compared with that of control （P 〈 0. 001 ）, and sTREM-1 of ISS ≥ 25 group was significantly higher than that of 16 ≤ ISS 〈 25 group （P 〈 0. 05 ）. sTREM-1 level correlated closely with TNF- α level （ r = 0. 845, P 〈 0. 05 ）, but did not correlate with CRP （ r = 0. 426, P 〉 0. 05 ）. In patients with sepsis, sTREM-1 on 1,2 and 7 d was （25. 1± 2. 2）, （31.9 ± 2. 6） and （25.2 ± 1.9） ng/L, respectively. In patients without sepsis, sTREM-1 on 1, 2 and 7 d was （ 15.8 ± 1.3）, （24. 2 ±2. 0） and （ 13.9 ± 1.5） ng/L, respectively, sTREM-1 of patients with sepsis was significantly higher than that of patients without sepsis （P 〈 0. 05）. Conclusions Serum sTREM-1 correlates closely with ISS, TNF-α and onset of sepsis, indicating that it may play an important role in the development of sepsis in patients with multiple traumas.