胸外科术后感染血清sTREM-1、IL-1β、sCD14表达预测感染价值及对预后影响

Predictive value of serum sTREM-1,IL-1βand sCD14 expression in infection and prognosis after thoracic surgery

目的探讨胸外科术后感染患者血清可溶性髓系细胞触发受体-1(sTREM-1)、白介素-1β(IL-1β)、可溶性白细胞分化抗原14(sCD14)表达预测感染价值及对预后影响。方法选取2017年3月-2019年12月江苏省南通大学附属医院胸外科术后感染患者113例设为研究组,并选取同期临床资料相似的胸外科术后无感染患者113例设为对照组。比较两组、研究组不同预后患者血清sTREM-1、IL-1β、sCD14水平,采用Logistic多元回归分析胸外科术后感染的相关影响因素,采用接收者操作特征(ROC)曲线及其曲线下面积(AUC)分析各指标预测胸外科术后感染的价值,采用Cox回归方程分析感染患者预后的相关影响因素。结果研究组sTREM-1、IL-1β、sCD14血清水平高于对照组(P<0.05);sTREM-1、IL-1β、sCD14预测胸外科术后感染的AUC分别为0.722、0.806、0.814,三个指标联合预测胸外科术后感染的AUC为0.898;研究组病死者sTREM-1、IL-1β、sCD14血清水平高于生存者(P<0.05);APACHEⅡ评分、SOFA评分、sTREM-1、IL-1β、sCD14血清水平均为胸外科术后感染病死的影响因素(P<0.05)。结论胸外科术后感染患者血清sTREM-1、IL-1β、sCD14呈高表达,具有较高的感染预测效能和预后评估价值。

OBJECTIVE To investigate serum expression of serum soluble myeloid cell trigger receptor-1(sTREM-1),interleukin-1β(IL-1β)and soluble leukocyte differentiation antigen 14(sCD14)in patients with infection after thoracic surgery and to analyze the effect on the prediction of infection and prognosis.METHODS From Mar 2017 to Dec 2019,113 patients with postoperative infection after thoracic surgery in Nantong University Hospital of Jiangsu Province were recruited in the study group;113 patients without infection after thoracic surgery during the same period were enrolled in the control group.The serum levels of sTREM-1,IL-1βand sCD14 were compared between the two groups and in patients with different prognosis in the study group.Multivariate Logistic regression analysis was used to analyze the risk factors for infection after thoracic surgery.The receiver operating characteristic(ROC)curves and the area under ROC(AUC)were used to evaluate the value of each index in predicting postoperative infection after thracic surgery.Cox regression was used to analyze the related factors affecting the prognosis of infection.RESULTS The serum levels of sTREM-1,IL-1βand sCD14 in the study group were significantly higher than those in the control group(P<0.05);the AUCs of sTREM-1,IL-1β,and sCD14 in the prediction of post-thoracic surgery infections were 0.722,0.806 and 0.814,respectively;and AUC of the combination of the three indicators was 0.898.The serum levels of sTREM-1,IL-1βand sCD14 in the dead of the study group were significantly higher than those in the living(P<0.05).APACHEⅡscore,SOFA score,sTREM-1,IL Serum levels of-1βand sCD14 level were risk factors for the poor prognosis of infection after thoracic surgery(P<0.05).CONCLUSION Serum sTREM-1,IL-1β,and sCD14 are highly expressed in patients with postoperative infec-tion after thoracic surgery,which may have good effect on the prediction of infection and evaluation of prognosis.