动态监测血清TREM-1和LPS水平对重症胰腺炎早期诊断价值

Dynamic monitoring of serum TREM-1 and LPS levels for early diagnosis of severe pancreatitis

目的研究动态监测血清髓样细胞触发受体-l(triggenng receptors expressed on myeloid cells-1,TREM-1)和脂肪酶(lipase,LPS)水平对重症胰腺炎(severeacutepancreatitis,SAP)早期诊断价值。方法选取广西南宁市第二人民医院五象医院2017年1月-2019年1月诊治的120例SAP患者作为观察组(SAP组),120例轻型急性胰腺炎(mild acute pancreatitis,MAP)患者作为对照组(MAP组)。另选取同期健康体检者80例作为健康对照组。采用酶联免疫吸附试验对健康对照组、SAP组与MAP组TREM-1进行检测,采用速率法对3组LPS水平进行检测,同时采用受试者工作特征(receiver operating characteristic,ROC)曲线对各项指标的敏感度和特异度进行评价。结果对照组和MAP组第1天TREM-1水平明显低于SAP组(P<0.05),MAP组TREM-1水平高于健康对照组(P<0.05)。入院第7天SAP组和MAP组TREM-1水平较之前下降,两组第1、3、5、7天血清TREM-1水平比较差异具有统计学意义(t=11.62、9.44、8.13、3.92,P<0.05)。入院当天MAP组LPS水平高于健.康对照组(P<0.05)。入院第7天SAP组和MAP组LPS水平较之前下降(P<0.05)。结论TREM-1和LPS水平在SAP中表达水平较高,由于LPS敏感度不高,其在早期SAP评估中的诊断价值明显差于TREM-1。TREM-1可作为判断早期SP病情严重程度的重要指标。

Objective Study Dynamic Monitoring of Serum Myeloid Cells Triggering Receptor-1(TREM-1)and Lipase(LPS)Levels for Early Diagnosis of Severe Acute Pancreatitis(SAP)value.Methods 120 patients with SAP diagnosed and treated in Wuxiang Hospital of Nanning Second Peopled Hospital of Guangxi from January 2017 to January 2019 were selected as the observation group(SAP group)and 120 patients with mild acute pancreatitis(MAP)were used as controls Group(MAP group).Another 80 healthy subjects were selected as healthy control group.Enzyme-linked immunosorbent assay was used to detect TREM-1 in healthy control group,SAP group and MAP group.The rate method was used to detect LPS levels in three groups,and receiver operating characteristic(ROC)curves were used.The sensitivity and specificity of each index were evaluated.Results The TREM-1 level of the control group and the MAP group on the first day was significahtly lower than that of the SAP group(P<0.05),and the TREM-1 level of the MAP group was higher than that of the healthy control group(P<0.05).On the 7th day after admission,the TREM-1 levels in the SAP and MAP groups were lower than before.The serum TREM-1 levels in the two groups were significantly different on the 1,3,5,and 7 days(t=11.62,9.44,8.13,3.92,P<0.05).On the day of admission,the LPS level in the MAP group was higher than that in the healthy control group(P<0.05).On the seventh day of admission,LPS levels in the SAP and MAP groups were lower than before(P<0.05).Conclusion The levels of TREM—1 and LPS are higher in SAP.Due to the low sensitivity of LPS,their diagnostic value in early SAP assessment is significantly worse than TREM-1.TREM-1 can be used as an important indicator to determine the severity of early SP disease.