重症肺炎患者血管外肺水指数与血浆可溶性髓样细胞触发受体-1的关系

The correlation of extravascular lung water index with plasma doluble triggering receptor expressed on myeloid cell 1 in patients with severe pneumonia

目的探讨重症肺炎患者血管外肺水指数(EVLWI)与血浆可溶性髓样细胞触发受体-1(sTREM-1)的关系。方法选取2012年2月一2015年5月广东医学院附属医院重症医学科收治的重症肺炎患者32例,根据28d预后分为生存组(n=23)和死亡组(n=9),动态监测患者入ICU第1、3、5天EVLWI、肺毛细血管通透性指数(PVPI)的变化及血浆sTREM-1水平,分析EVLWI、PVPI与血浆sTREM-1水平的相关性。结果重症肺炎患者生存组与死亡组在入ICU第1天EVLWI、PVPI、sTREM-1水平无显著差异(P>0.05);生存组患者血浆EVLWI、PVPI、sTREM-1水平在入ICU第1、3、5天随时间推移逐渐下降(P<0.05),而死亡组无明显波动(P>0.05);第3、5天死亡组EVLWI、sTREM-1水平显著高于生存组(P<0.05),第5天PVPI水平显著高于生存组(P<0.05);EVLWI、PVPI与sTREM-1水平呈显著正相关(r=0.457、0.412,P<0.05)。结论 EVLWI、PVPI可以间接反映重症肺炎患者体内炎性因子的水平,有助于评估重症肺炎患者的病情。

Objective To investigate the relationship between the serum levels of EVPWI in patients with severe pneumonia and the plasma soluhle triggering reeeptor-1（sTREM-1）.Methods A total of 32 eases of patients with severe pneumonia from February 2012 to May 2015 at Guangdong Medical College Affiliated Hospital were enrolled,they were divided according to 28 day prognosis into survival group（n =23） and death group（n = 9）,dynamic monitoring patients in ICU 1,3,5 day＇s EVLWI and pulmonary microvascular permeability determination（PVPI） and changes of plasma sTREM-1 level.Analysis EVLWI and PVPI and plasma sTREM-1 level＇s correlation.Results Palienls with severe pneumonia,death and survival group had no significant difference（P〉0.05） of first day ICU admission＇s EVLWI,PVP1,sTREM-1 level;the survival group＇s plasma EVLWI,PVPI,sTREM-1 level in the first and third,fifth days gradually decreased（P〈0.05）,whereas no significant fluctuations in the death group（P〉0.05）;at third,fifth days,death group＇s EVLWI,sTREM-l levels were significantly higher than the survival group（P〈0.05）,the fifth day＇s PVPI was significantly higher than survival group（P〈0.05.）;EVLWI,PVPI and sTREM-l levels were significantly correlated（r =0.457,r =0.412,P〈0.05）.Conclusion PVPI,EVLWI can indirectly reflect the level ol inflammatory factors in patients with severe pneumonia,help to assess the condition of patients with severe pneumonia.