血清可溶性髓样细胞触发受体1对活动性肺结核的早期预警和预后判断价值

The early warning and prognostic value of serum soluble TREM-1 for active pulmonary tuberculosis

目的检测活动性肺结核(ATB)患者血清可溶性髓样细胞触发受体1(s TREM-1)含量并分析其临床意义。方法收集东莞市慢性病防治院确诊的ATB患者78例和健康志愿者40例,全自动血球分析仪检测外周血中性粒细胞和单核细胞绝对值,ELISA检测血清s TREM-1含量,Pearson相关分析其相关性。结果 ATB患者外周血中性粒细胞绝对值,单核细胞绝对值和血清s TREM-1含量均显著增高,且痰涂片结核分枝杆菌(MTB)阳性患者显著高于痰涂片MTB阴性患者,常规抗结核药物治疗前显著高于治疗后。以528.14 pg/m L为血清s TREM-1含量检测截断点时,痰涂片MTB阳性的结核确诊率为100%。Pearson相关性分析显示ATB患者外周血中性粒细胞和单核细胞绝对值均与患者血清s TREM-1含量呈正相关。结论 s TREM-1对ATB的早期预警及预后有重要参考价值。

Objective To investigate the role of serum soluble triggering receptor expressed on myeloid cells-1 （sTREM-1） in patients with active pulmonary tuberculosis （ATB） and explore its clinical significance. Methods The study included 78 cases of ATB patients and 40 cases of healthy volunteers from Dongguan Hospital for Chronic Diseases. Peripheral blood neutrophils and monocytes were counted by automated hematology analyzer. Serum sTREM-1 levels were detected by ELISA, and then the relevance with neutrophils and monocytes were analyzed by Pearson correlation test, respectively. Results The absolute numbers of neutrophils and monocytes, and the levels of serum sTREM-1 were higher in ATB patients than those in normal controls. In smear positive patients, the absolute numbers of neutrophils and monocytes, and the levels of serum sTREM-1 were higher than those in smear negative patients. The absolute numbers of neutrophils and monocytes, and the levels of serum sTREM-1 decreased in ATB patients after anti-TB drug treatments. Serum sTREM-1 level ≥528.14 pg/mL was very useful to diagnosis the smear positive ATB, and the accuracy was 100%. Pearson correlation test revealed that the absolute numbers of neutrophils and monocytes were both positively correlated to the levels of serum sTREM-1. Conclusion High serum levels of sTREM-1 may be of high value for early warning and prediction of poor prognosis in ATB patients.