脓毒症患者外周血FOX03aTREM-1与PCT表达水平及其临床意义

目的监测脓毒症患者外周血中FOX03a、TREM—1及PCT的表达情况，并分析其临床意义。方法2015年1月至2017年1月脓毒症患者144例，依照病情分为脓毒症组40例、严重脓毒症组48例及脓毒症休克组56例，选取50例体检健康者为健康对照组；入院时及治疗结束2周时采用免疫荧光色谱法检测患者血清中PCT水平，采用酶联免疫吸附法检测血TREM-1水平，采用实时荧光定量聚合酶链反应法检测PBMC中FOX03a水平，在对脓毒症患者病情进行评估时，FOXO3a、TREM-17及PCT均具有较高的诊断精确度、灵敏度，且三者诊断效能差异无统计学意义（P〉0.05）。结果三组患者血中PCT及TREM-1水平均显著高于健康对照组（P〈0．05），且FOXO3a水平显著低于健康对照组（P〈0．05），且随着患者病情加重，患者PCT及CEM-1水平显著升高（P〈0．05），且FOXO3a显著降低（P〈0．05）；治疗后三组患者血中PCT与TREM-1水平显著降低（P〈0．05），且FOXO3a水平显著升高（P〈0.05）。结论FOX03a、TREM-17及PCT的表达与脓毒症患者病情密切相关，对上述三指标水平进行检测，在评估脓毒症患者病情及预后中有一定的指导意义。

Objective Monitor the expression of FOXO3a, TREM-1 and PCT in the blood of patients with sepsis, and to analyze the chnical significance. Methods From January 2015 to January 2017 in our hospital 144 cases of sepsis patients according to disease divided into sepsis group （ n=40 ） , severe sepsis group （ n=48 ） and septic shock group （ n=56 ） , and 50 healthy people were selected as healthy control group at the time of admission. After 2 weeks of the end of treatment, immune fluorescence detection was adopted to detect the level of PCT in serum of patients. TREM- 1 levels were detected by enzyme-linked immunosorbent assay in blood. The level of FOXO3a by real-time fluorescence quantitative polymerase chain reaction assay in PBMC. Results PCT and TREM-1 levels in sepsis group, severe sepsis group and septic shock group patients were significantly higher than those in healthy control group （P〈0.05） , and the FOXO3a level was significantly lower than that of control group （ P〈0.05 ） , and with the aggravation of disease, PCT and TREM-1 levels were significantly increased （P〈0.05） , and FOXO3a significantly decreased （P〈0.05） ; the levels of PCT and TREM-1 after treatment in patients with sepsis group significantly decreased （P〈0.05） , and the FOXO3a level increased significantly （P〈0.05） ; the levels of PCT and TREM-1 after treatment in patients with severe sepsis group decreased significantly （P〈0.05） , and the FOXO3a level increased significantly （P〈0.05） the levels of PCT and TREM-1 after the treatment of septic shock patients in blood decreased significantly （P〈0.05） , and the FOXO3a level increased significantly （P〈0.05） . In the evaluation of sepsis patients, FOXO3a, TREM-1 and PCT had higher diagnostic accuracy and sensitivity, and there was no significant difference in the diagnostic efficacy among the three groups （P〉0.05） . Conclusions The expression ofFOXO3a, TREM-I and PCT is closely related to the severity of sepsis, and the detection of these three indexes is of some guiding significance in evaluating the condition and prognosis of patients with sepsis.