不同体液sTREM-1及血清sCD163检测在呼吸机相关性肺炎诊断中的临床意义

Clinical significance of different body fluids sTREM-1 and Serums CD163 in the diagnosis of ventilator-associated pneumonia

目的:研究可溶性髓样细胞触发受体1(sTREM-1)与可溶性血红蛋白清道夫受体(sCD163)单独和联合检测在呼吸机相关性肺炎(VAP)诊断中的影响。方法:选择2019年1月—2019年11月期间湖北省第三人民医院ICU的VAP患者、非VAP患者共95例,测定两组患者支气管肺泡灌洗液(BALF)、气管导管抽吸物(EA)、呼吸机呼出气冷凝液(EVC)中的sTREM-1水平,并测定血清中的sTREM-1和sCD163水平,分析两组患者sTREM-1与sCD163水平差异及两者的相关性,并与血清中CRP、PCT等指标进行比较。结果:VAP组患者C-反应蛋白及降钙素原均显著高于非VAP组患者,P<0.05;与非VAP组比较,VAP组患者血清sTREM-1和sCD163水平显著升高,其差异具有统计学意义(P<0.05);VAP组治疗前较VAP治疗第3天、第7天血清sTREM-1和sCD163升高,其差异具有统计学意义(P<0.05);与VAP组治疗前相比,VAP治疗第3天、VAP治疗第7天、非VAP组BALF、EA、EVC中sTREM-1表达水平依次降低,其差异具有统计学意义(p<0.05);VAP组治疗前血清sTREM-1与sCD163之间呈正相关(r=0.558,P<0.001)。结论:sTREM-1、sCD163及其联合检测在呼吸机相关性肺炎具有较好的诊断意义,可以为呼吸机相关性肺炎的治疗提供参考。

Objective: To investigate the effects of soluble myeloid cell trigger receptor-1(sTREM-1) and soluble hemoglobin scavenger receptor(sCD163) in the diagnosis of ventilator-associated pneumonia(VAP) alone or in combination. Methods: To measure the sTREM-1 levels of bronchoalveolar lavage fluid(BALF), trachea catheter aspirate(EA), ventilator exhaled air condensate(EVC), and sTREM-1 and sCD163 levels in the serum of the groups of VAP and the non-VAP patients, 95 cases which were included ICU VAP patients and the non-VAP patients in the third people’s hospital of HuBei Province from January 2019 to November 2019 were involved. differences and correlation between sCD163 and sTREM-1 level was studied, CRP and PCT were also studied. Results: C-reactive protein and Procalcitonin were significantly higher in the VAP group than in the non-VAP group(P<0.05). Compared with non-VAP group, serum sTREM-1 and sCD163 level was significantly increased in VAP group, with a statistically significant difference(P<0.05). The level of serum sTREM-1 and sCD163 in the VAP group before treatment was higher than that in the VAP group on day 3, day 7 and the difference was statistically significant(P<0.05). Compared with the VAP group, The expression of sTREM-1 in BALF, EA and EVC decreased on the 3 rd day of VAP treatment, 7 th day of VAP treatment and non VAP group(p<0.05). There was a positive correlation between serum sTREM-1 and sCD163 in the VAP group before treatment(r=0.558, P<0.001). Conclusion: The detection of sTREM-1, sCD163 and their combined detection have good diagnostic significance for ventilator-associated pneumonia(VAP), and can provide reference for the treatment of ventilator-associated pneumonia(VAP).