sTREM-1、IL-8在肺挫伤患者中的动态变化及其对患者预后的预测价值分析

Dynamic changes of sTREM-1 and IL-8 in patients with pulmonary contusion and their prognostic value

目的:探讨肺挫伤患者血清可溶性髓系细胞触发受体-1(sTREM-1)、白细胞介素-8(IL-8)的动态变化及其对患者预后的预测价值。方法:分别将肺挫伤、单纯肋骨骨折及健康体检者设为肺挫伤组(n=98)、肋骨骨折组(n=70)和对照组(n=68);比较三组对象第1天、第3天、第7天血清sTREM-1、IL-8水平及其在肺挫伤患者血清中的动态变化情况。肺挫伤组再依据病情分为轻度组(n=30)、中度组(n=45)和重度组(n=23);根据1个月后愈合情况分为预后良好组(n=80)和预后不良组(n=18),比较不同病情及不同预后肺挫伤患者第1天、第3天、第7天血清sTREM-1、IL-8水平,分析其对患者预后评估的价值。结果:肺挫伤组及肋骨骨折组患者不同时间点血清sTREM-1、IL-8水平均高于对照组(P<0.05),且肺挫伤组高于肋骨骨折组(P<0.05),第3天及第7天低于第1天,第7天低于第3天(P<0.05);肺挫伤中度组及重度组不同时间点血清sTREM-1、IL-8水平高于轻度组(P<0.05),且重度组高于中度组(P<0.05),第3天及第7天低于第1天,第7天低于第3天(P<0.05);预后不良组不同时间点血清sTREM-1、IL-8水平高于预后良好组(P<0.05),且第3天及第7天低于第1天,第7天低于第3天(P<0.05);血清sTREM-1、IL-8单独及联合评估肺挫伤预后的AUC分别为0.761、0.751、0.860(P<0.05)。结论:肺挫伤患者血清sTREM-1、IL-8明显上调,且水平越高,肺挫伤越重,预后越差,二者均可作为评估患者预后的重要指标之一。

Objective:To explore the changes of serum soluble triggering receptor expressed on myeloid cells-1(sTREM-1)and interleukin-8(IL-8)in patients with lung contusion,and analyze their prognostic value.Methods:Include 98 inpatients with lung contusion as the lung contusion group,and 70 inpatients with simple rib fracture during the same period as the rib fracture group,and selected for physical examination during the same period 68 of the healthy physical examinees served as the control group.The serum sTREM-1 and IL-8 levels of the three groups of subjects on the 1st,3rd,and 7th days were compared,and the dynamic changes of the two in the serum of patients with lung contusion were analyzed.According to the severity of lung contusion patients,they were divided into mild group(n=30),moderate group(n=45),and severe group(n=23),according to the healing condition after 1 month,the patients were divided into good prognosis group(n=80)and poor prognosis group(n=18).The levels of serum sTREM-1 and IL-8 were compared on the 1st,3rd and 7th day in patients with pulmonary contusion of different conditions and different prognosis,and the value of serum sTREM-1 and IL-8 in evaluating the prognosis of patients was analyzed.Results:The serum sTREM-1 and IL-8 of the lung contusion group and the rib fracture group were higher than those of the control group on the 1st,3rd,and 7th days(P<0.05).The serum sTREM-1 and IL-8 of the lung contusion group were higher than those of the rib fracture group(P<0.05).The serum sTREM-1 and IL-8 on the 3rd and 7th day were significantly lower than that on the 1st day,and the serum sTREM-1 and IL-8 on the 7th day were lower than that on the 3rd day(P<0.05).Serum sTREM-1 and IL-8 on the 1st,3rd,and 7th day of the moderate and severe groups were higher than those of the mild group(P<0.05),and the severe group was higher than the moderate group(P<0.05),and the serum sTREM-1 and IL-8 levels of the three groups on the 3rd and 7th day was significantly lower than on lst day,and serum sTREM-1 and IL-8 on 7th day were lower than that on 3rd day(P<0.05).The serum sTREM-1 and IL-8 of the poor prognosis group on the 1st,3rd,and 7th day were higher than those of the good prognosis group(P<0.05),and the serum sTREM-1 and IL-8 of the two groups on the 3rd and 7th day were significantly lower than those on the 1st day.Serum sTREM-1 and IL-8 on 7th day were lower than those on 3rd day(P<0.05).The AUC of serum sTREM-1 and IL-8 alone and in combination to assess the prognosis of lung contusion were 0.761,0.751,and 0.860,respectively(P<0.05).Conclusion:The serum levels of sTREM-1 and IL-8 in patients with pulmonary contusion are significantly increased,the higher the level,the more severe the pulmonary contusion and the worse the prognosis,and both can be used as important indicators for predicting the prognosis of pulmonary contusion.