血清sTREM-1联合SIRS评分对烧伤患者并发脓毒症的诊断效能

Efficacy of serum sTREM-1 combined with SIRS score in the diagnosis of sepsis in burn patients

目的探讨烧伤患者血清可溶性髓样细胞触发受体1(sTREM-1)及全身炎症反应综合征(SIRS)评分的变化,以及两指标对烧伤患者并发脓毒症的诊断价值。方法选择2019年3月-2020年10月山东省立第三医院收治的193例烧伤患者,其中局部感染65例(局部感染组),合并脓毒症38例(脓毒症组),单纯烧伤90例(单纯烧伤组)。检测血清sTREM-1水平,进行SIRS评分,采用受试者工作特征曲线(ROC)分析sTREM-1联合SIRS评分诊断烧伤并发脓毒症的价值。结果脓毒症组血清sTREM-1水平[(169.83±31.54)ng/mL、(124.05±24.09)ng/mL、(72.18±11.58)ng/mL],SIRS评分[3.5(2.0,4.0)分、1.5(1.0,2.0)分、0.5(0,1.0)分]高于局部感染组和单纯烧伤组(P<0.05),局部感染组血清sTREM-1水平、SIRS评分高于单纯烧伤组(P<0.05)。Logistic回归分析结果显示,高水平sTREM-1(OR=2.003,95%CI:1.945~2.135)是烧伤患者合并脓毒症的危险因素(P<0.05)。ROC分析结果显示sTREM-1、SIRS评分、联合sTREM-1和SIRS评分诊断烧伤患者合并脓毒症的曲线下面积(AUC)分别为0.731、0.629、0.943,联合诊断高于单独sTREM-1、SIRS评分(P<0.05)。结论sTREM-1、SIRS评分在烧伤患者并发脓毒症诊断方面具有一定的价值,联合两项指标可提高诊断效能。

Objective To explore the changes of serum soluble medullary cell trigger receptor 1(sTREM-1) and systemic inflammatory response syndrome(SIRS) scores in burn patients, and the diagnostic value of the two indexes in burn patients complicated with sepsis. Methods A total of 193 burn patients admitted to Shandong Provincial Third Hospital from March 2019 to October 2020 were selected, including 65 cases of local infection(local infection group), 38 cases of sepsis(sepsis group), and 90 cases of simple burn(simple burns group). Serum sTREM-1 level was detected and SIRS score was performed. The value of sTREM-1 combined with SIRS score in diagnosing burn complicated sepsis was analyzed by receiver operating characteristic curve(ROC). Results Serum sTREM-1 level [(169.83±31.54) ng/mL,(124.05±24.09) ng/mL,(72.18±11.58) ng/mL] and SIRS score [3.5(2.0, 4.0) vs, 1.5(1.0, 2.0), 0.5(0, 1.0)] in the sepsis group were higher than those in the local infection group and the Simple burns group(P<0.05), and serum sTREM-1 level and SIRS score in the local infection group were higher than those in the simple burns group(P<0.05). Logistic regression analysis showed that high sTREM-1 level(OR=2.003, 95% CI: 1.945-2.135) was a risk factor for sepsis in burn patients(P<0.05). ROC analysis showed that the AUC of sTREM-1, SIRS score, combined sTREM-1 and SIRS score in the diagnosis of burn patients with sepsis were 0.731, 0.629 and 0.943, respectively, and the combined diagnosis was higher than that of sTREM-1 and SIRS score alone(P<0.05). Conclusion sTREM-1 and SIRS score have certain value in the diagnosis of sepsis in burn patients, and the combination of the two indexes can improve the diagnostic efficiency.