血浆sTREM-1、sFLT-1水平与重症肺炎APACHEⅡ评分的关联性

Correlation between plasma levels of sTREM-1,sFLT-1 and APACHEⅡscore of severe pneumonia

目的研究血浆可溶性髓样细胞触发受体1(sTREM-1)、可溶性血管内皮生长因子受体(sFLT-1)与重症肺炎患者急性生理学及慢性健康状况(APACHEⅡ评分)的关联性。方法选取2018年11月至2019年11月间郑州市第六人民医院收治的94例重症肺炎患者,并按照1∶1∶1的比例选取普通肺炎患者94例及健康体检者94人,检测血浆sTREM-1和sFLT-1水平,并测定其APACHEⅡ评分。比较三组受试者血浆sTREM-1、sFLT-1水平、APACHEⅡ评分及第1天、第3天、第7天重症肺炎患者中生存、死亡的患者血浆sTREM-1、sFLT-1水平及APACHEⅡ评分,并分析上述指标的关联性。结果重症肺炎患者血浆sTREM-1、sFLT-1水平高于普通肺炎患者和健康体检者,且普通肺炎患者高于健康体检者(P<0.05);重症肺炎患者APACHEⅡ评分高于普通肺炎患者(P<0.05);94例重症肺炎患者中64例生存、30例死亡;不同预后、时间点、预后·时间点交互作用血浆sTREM-1、sFLT-1水平及APACHEⅡ评分对比有差异(P<0.05);第1天、第3天、第7天重症肺炎患者中死亡患者者血浆sTREM-1、sFLT-1水平及APACHEⅡ评分均高于生存患者;且随着病程延长,生存患者血浆sTREM-1、sFLT-1水平及APACHEⅡ评分呈下降趋势,死亡患者呈上升趋势(P<0.05);经Pearson相关性分析,血浆sTREM-1、sFLT-1水平与APACHEⅡ评分呈正相关性(r1=0.695,r2=0.723,P<0.05)。结论重症肺炎患者血浆sTREM-1、sFLT-1水平会显著升高,能反映病情程度,且与APACHEⅡ评分呈正相关,可预测死亡情况,有助于临床预后情况的判断,指导治疗方案的制定。

Objective To study the relationship between plasma soluble myeloid cell trigger receptor 1(sTREM-1),soluble vascular endothelial growth factor receptor(sFLT-1)and acute physiology and chronic health status(APACHE Ⅱ score)in patients with severe pneumonia.Methods Ninety-four patients with severe pneumonia admitted to the Sixth People’s Hospital of Zhengzhou from November 2018 to November 2019 were selected.According to the ratio of 1∶1∶1,94 patients with general pneumonia and 94 healthy persons were selected for plasma testing.sTREM-1 and sFLT-1 levels,and determine their APACHE Ⅱ score.To compare the plasma levels of sTREM-1,sFLT-1,APACHE Ⅱ score,and the levels of plasma sTREM-1,sFLT-1 and APACHE Ⅱ in patients with severe pneumonia that survived and died on the 1 st,3 rd,and 7 th days among the three groups of subjects Score and analyze the relevance of the above indicators.Results The plasma levels of sTREM-1 and sFLT-1 in patients with severe pneumonia were higher than those in ordinary pneumonia patients and those on healthy physical examination,and patients with ordinary pneumonia were higher than those on healthy physical examination(P<0.05);the APACHE Ⅱ score of patients with severe pneumonia was higher than that of ordinary pneumonia patients(P<0.05);64 of 94 patients with severe pneumonia survived and 30 died;there were differences in plasma sTREM-1,sFLT-1 levels and APACHE Ⅱ scores in the interaction of different prognosis,time points,prognosis and time points(P<0.05)The plasma sTREM-1,sFLT-1 and APACHE Ⅱ scores of patients who died of severe pneumonia on the 1 st,3 rd,and 7 th days were higher than those of the surviving patients;and as the course of the disease prolonged,the plasma sTREM-1,The level of sFLT-1 and APACHE Ⅱ score showed a downward trend,and the number of deaths showed an upward trend(P<0.05).According to Pearson correlation analysis,plasma sTREM-1 and sFLT-1 levels were positively correlated with APACHE Ⅱ score(r1=0.695,r2=0.723,P<0.05).Conclusion The plasma levels of sTREM-1 and sFLT-1 in patients with severe pneumonia will increase significantly,which can reflect the severity of the disease,and are positively correlated with the APACHE Ⅱ score.It can predict death,help judge the clinical prognosis,and guide the formulation of treatment plans.