血清可溶性髓系细胞触发受体1、C反应蛋白在老年患者医院获得性肺炎中的应用研究

Application of serum soluble triggering receptor expressed on myeloid cell-1 and C-reactive protein in hospital-acquired pneumonia in elderly patients

目的探讨血清可溶性髓系细胞触发受体1(soluble triggering receptor expressed on myeloid cell-1,sTREM-1和C反应蛋白(C-reactive protein,CRP)在老年人医院获得性肺炎(hospital acquired pneumonia,HAP)的病理生理过程中的意义。方法实验1随机选择2015年12月～2017年3月就诊于我院的年龄≥65岁的医院获得性肺炎患者共31例,设为HAP患者组。正常对照组30例,检测血清sTREM-1、CRP。分析两组受试者血清sTREM-1、CRP浓度的差异,同时计算老年HAP组患者的临床肺部感染评分(Clinical pulmonary infection score,CPIS)。实验2选择患者26例给予正规抗感染治疗,并于治疗后第5、10天复查患者血清sTREM-1、CRP,并计算患者临床肺部感染评分(CPIS值),分析治疗前后血清sTREM-1、CRP浓度的变化以及患者血清sTREM-1、CRP浓度与CPIS的相关性以了解血清sTREM-1、CRP水平与老年人医院获得性肺炎严重程度的关系。结果患者组血清sTREM-1、CRP浓度较对照组显著升高(P<0.01)。治疗后患者CPIS及血清sTREM-1、CRP浓度均下降,差异有显著统计学意义(P<0.01),且血清sTREM-1、CRP浓度与CPIS评分呈正相关(P<0.01)。结论老年患者HAP可引起血清sTREM-1、CRP浓度的升高,且和HAP严重程度正相关,血清sTREM-1、CRP是老年HAP病情判断的重要指标。

Objective To investigate the role of soluble triggering receptor expressed on myeloid cell-1 (sTREM-1) and C-reactive protein (CRP) in the pathophysiological process in hospital acquired pneumonia (HAP) in the elderly. Methods Experiment 1. A total of 31 patients with hospital acquired pneumonia aged ≥65 years who were admitted in our hospital from December 2015 to March 2017 were randomLy selected and set as the HAP patient group. 30 people in the normal control group were tested for serum sTREM-1 and CRP. The differences of serum sTREM-1 and CRP concentrations between the two groups were analyzed, and the clinical pulmonary infection score(CPIS) in the elderly with HAP was calculated. Experiment 2. 26 patients were selected to receive regular anti-infective treatment. The serum sTREM-1 and CRP were reviewed on the 5th and 10th day after treatment. And the clinical lung infection score (CPIS value) was calculated. The change of serum sTREM-1 and CRP concentration before and after treatment, the correlation between serum sTREM-1, CRP concentrations and CPIS were analyzed to understand the relationship between serum sTREM-1, CRP levels and the severity of hospital acquired pneumonia in the elderly. Results The serum levels of sTREM-1 and CRP in the patients were significantly higher than those in the control group(P<0.01). After treatment, the concentrations of CPIS and serum sTREM-1 and CRP decreased, and the difference was statistically significant (P< 0.01). The serum sTREM-1 and CRP concentrations were positively correlated with CPIS score(P<0.01). Conclusion HAP in elderly patients can cause the increase of serum sTREM-1 and CRP concentrations, and is positively correlated with the severity of HAP. Serum sTREM-1 and CRP are important indicators for judging HAP in elderly patients.