血清超敏C反应蛋白联合髓样细胞触发受体-1对老年肺部细菌感染的诊断与预后评估价值

Diagnosis and prognostic evalnation value of serum high-sensitivity C-reactive protein combined with myeloid cell trigger receptor-1 in the elderly patients with pulmonary bacterial infection

目的分析联合检测血清hs-CRP及髓样细胞触发受体-1(TREM-1)水平对老年肺部细菌感染病人的诊断及病情评估价值。方法入选我院近期收治的老年肺部感染病人150例,其中细菌感染者90例为细菌组,根据肺炎严重指数(PSI)对病情进行分类,并根据病人的预后情况分为好转组与未好转组;60例非细菌感染者为其他组。另选取100例年龄>65周岁健康体检未见明显异常的健康者为健康组。比较3组血清hs-CRP和TREM-1的水平,比较细菌组不同病情分组、好转与未好转病人之间血清hs-CRP和TREM-1水平差异,并评估血清hs-CRP联合TREM-1诊断细菌性肺炎的价值。结果3组血清hs-CRP和TREM-1水平由高至低依次为细菌组、其他组、健康组(P<0.01)。随着病人肺炎严重程度增加,血清hs-CRP和TREM-1水平显著增高(P<0.01)。治疗后,好转组病人血清hs-CRP和TREM-1水平明显低于未好转组(P<0.01)。以血清hs-CRP>10.0 mg/L、TREM-1>50 ng/L为诊断肺部细菌性感染的阈值,二者联合诊断的灵敏度为97.78%,特异度为98.89%。结论在老年肺部细菌感染病人中,血清hs-CRP和TREM-1水平较其他感染及健康者明显升高,联合检测血清hs-CRP和TREM-1水平,可明确病人是否为细菌感染,亦可协助病情评估,判断其预后情况,为临床治疗提供针对性的指导。

Objective To analyze the diagnosis and disease assessment value of serum levels of high-sensitivity C-reactive protein(hs-CRP)and myeloid cell trigger receptor-1(TREM-1)in in the elderly patients with pulmonary bacterial infection.Methods A total of 150 elderly patients with pulmonary infection admitted to our hospital from June 2018 to June 2019 were enrolled in this study,90 cases presenting with bacterial infection were divided into bacterial group,and the other 60 cases were divided into non-bacterial group.Another 100 healthy elderly were enrolled as the healthy group.The serum levels of hs-CRP and TREM-1 were detected in all the subjects and compared between the groups.Results The levels of hs-CRP and TREM-1 were highest in the bacteria group,followed by non-bacterial group and healthy group(P<0.01).With the increase of the severity of pneumonia,the levels of hs-CRP and TREM-1 increased significantly(P<0.01).After treatment,the levels of hs-CRP and TREM-1 in the improved group were significantly lower than those in the non-improved group.The combination of serum hs-CRP>10.0 mg/L and serum TREM-1>50 ng/L was used as the diagnostic index of pulmonary bacterial infection,and the sensitivity and specificity was 97.78%and 98.89%,respectively.Conclusions The levels of serum hs-CRP and TREM-1 in the elderly patients with pulmonary bacterial infection are significantly higher.Serum hs-CRP combined with TREM-1 could be used in the diagnosis and disease assessment for pulmonary bacterial infection in the elderly patients.