可溶性髓样细胞触发性受体-1清除率评估脓毒症休克患者预后的价值

Value of clearance rate of sTREM-1c in assessing prognosis in patients with septic shock

目的监测脓毒症休克患者可溶性髓样细胞触发性受体-1(s TREM-1)及s TREM-1清除率(s TREM-1c)的动态变化,探讨其判断预后的价值。方法收集我科2016年1-12月患者共54例,分为好转组和死亡组,通过监测脓毒症休克患者第1、5、7、9天s TREM-1及s TREM-1c水平;采用受试者工作特征曲线分析上述指标判断预后的价值。结果两组基线比较APACHEⅡ评分、PCT、年龄差异有统计学意义,经治疗后s TREM-1水平呈下降趋势,好转组下降优于恶化组。同样,s TREM-1c在好转组第5、7、9天下降明显高于死亡组(P<0.05),其次,不同时间点PCT、s TREM-1、s TREM-1c及24 h内APACHEⅡ评分AUC依次为s TREM-1 7、APACHEⅡ及s TREM-1 5、PCT、s TREM-1 9、s TREM-1c 9及s TREM-1 1,最小为s TREM-1c5及s TREM-1c 7。结论在临床上可动态监测s TREM-1并进行s TREM-1c分析,比单纯监测s TREM-1可能更优越。

Objective To monitor the dynamic change of soluble myeloid cells trigger receptor 1 （sTREM- 1 ） and the clearance rate of sTREM-I （sTREM-Ic ） in patients with sepsis shock and to explore its value in assessing the prognosis. Methods A total of 54 patients from January to December 2016 were divided into improved group and death group, sTREM-1 and sTREM-lc level at 1,5,7 and 9 d were monitored and the receiver-operating char- acteristic curve analysis was used to judge its value in prognosis. Results Comparison of baseline of APACHE 11 score, PCT and age in 2 groups was statistically significant. After treatment, the sTREM-1 level declined, especial- ly in improved group. Similarly, sTREM-lc in improved group at 5,7 and 9 d dropped more significantly than that in death group （P 〈 0.05 ）. At different time points, sTREM-1 7 topped the predictive value of AUC on the prognosis, followed by APACHE II and sTREM-1 5, PCT, sTREM-1 9, sTREM-Ic 9 and sTREM-1 1, and sTREM-Ic 5 and sTREM-lc 7 were the minimum. Conclusion Effect of dynamic monitoring of sTREM-1 and sTREM-lc analy- sis in clinic is better than that of simply monitoring of sTREM- 1.