血清可溶性髓样细胞触发受体-1及环氧合酶-2对腹腔感染致脓毒症的诊断及预后评估价值

Diagnostic and prognostic value of serum soluble triggering receptor expressed on myeloid cell-1 and cyclooxygenase-2 in abdominal infection-caused sepsis

目的 研究血清可溶性髓样细胞触发受体-1(soluble triggering receptor expressed on myeloid cell-1,sTREM-1)和环氧合酶-2(cyclooxygenase-2, COX-2)对腹腔感染致脓毒症的诊断及预后评估价值。方法 回顾性选择2019年1月—2022年3月秦皇岛市第一医院收治的170例腹腔感染患者,根据是否合并脓毒症分为脓毒症组(n=76)和非脓毒症组(n=94);另选择同期80例健康体检者作为对照组。检测3组受试者的血清sTREM-1及COX-2的水平并比较差异。检测腹腔感染致脓毒症患者的实验室指标白细胞计数、超敏C反应蛋白、降钙素原,评价腹腔感染致脓毒症患者的序贯器官衰竭评分、急性生理学和慢性健康状况评分系统Ⅱ及预后(包括生存或死亡),分析血清sTREM-1及COX-2与脓毒症病情的相关性,评价两指标对腹腔感染致脓毒症的诊断及预后评估价值。结果 脓毒症组患者的血清sTREM-1及COX-2水平均高于对照组、非脓毒症组(P<0.05)。脓毒症组患者的血清sTREM-1、COX-2水平与白细胞计数、超敏C反应蛋白、降钙素原、序贯器官衰竭评分、急性生理学和慢性健康状况评分系统Ⅱ评分均呈正相关(P<0.05)。脓毒症组中住院期间死亡患者的血清sTREM-1、COX-2水平高于存活患者(P<0.05)。血清sTREM-1及COX-2水平诊断腹腔感染致脓毒症时的受试者操作特征曲线下面积分别为0.814[95%置信区间(confidence interval, CI)(0.746,0.882),P<0.001]和0.848[95%CI(0.788,0.905),P<0.001],临界值分别为1.879 pg/mL和18.75 ng/mL;预测腹腔感染致脓毒症患者的预后时的受试者操作特征曲线下面积分别为0.775[95%CI(0.659,0.890),P<0.001]和0.784[95%CI(0.679,0.889),P<0.001],临界值分别为2.283 pg/mL和23.02 ng/mL。结论 血清sTREM-1及COX-2水平在腹腔感染致脓毒症诊断及预后预测中具有一定价值。

Objective To study the diagnostic and prognostic value of serum soluble triggering receptor expressed on myeloid cell-1(sTREM-1)and cyclooxygenase-2(COX-2)in abdominal infection-caused sepsis.Methods A total of 170 patients with abdominal infection treated in the First Hospital of Qinhuangdao between January 2019 and March 2022 were retrospectively selected and divided into sepsis group(n=76)and non-sepsis group(n=94)according to whether they were combined with abdominal infection-caused sepsis.In addition,80 healthy people in the same period were selected as the control group.The levels of serum sTREM-1 and COX-2 in the three groups were detected and the differences were compared.The laboratory indexes,including white blood cell count,high-sensitivity C-reactive protein,and procalcitonin of patients with abdominal infection-caused sepsis were detected.The Sequential Organ Failure Assessment score,Acute Physiology and Chronic Health Evaluation SystemⅡand prognosis(survival or death)of patients with abdominal infection-caused sepsis were evaluated.The correlations of serum sTREM-1 and COX-2 with the severity of sepsis were analyzed,and the diagnostic and prognostic value of sTREM-1 and COX-2 in abdominal infection-caused sepsis was assessed.Results The levels of serum sTREM-1 and COX-2 in the sepsis group were higher than those in the control group and the non-sepsis group(P<0.05).The levels of serum sTREM-1 and COX-2 in the sepsis group were positively correlated with white blood cell count,high-sensitivity C-reactive protein,procalcitonin,Sequential Organ Failure Assessment score,Acute Physiology and Chronic Health Evaluation SystemⅡscore(P<0.05).The serum levels of sTREM-1 and COX-2 of patients who died during hospitalization in the sepsis group were higher than those of the surviving patients.The areas under the receiver operating characteristic curves of the serum sTREM-1 and COX-2 levels for diagnosing sepsis caused by abdominal infection were 0.814[95%confidence interval(CI)(0.746,0.882),P<0.001]and 0.848[95%CI(0.788,0.905),P<0.001],respectively,with critical values of 1.879 pg/mL and 18.75 ng/mL,respectively,and those for predicting the prognosis of patients with sepsis caused by abdominal infection were 0.775[95%CI(0.659,0.890),P<0.001]and 0.784[95%CI(0.679,0.889),P<0.001],respectively,with critical values of 2.283 pg/mL and 23.02 ng/mL,respectively(P<0.05).Conclusion The serum levels of sTREM-1 and COX-2 have certain value in the diagnosis and prognosis prediction of abdominal infection-caused sepsis.