血清可溶性髓样细胞触发受体-1水平与慢性阻塞性肺疾病急性加重期患者临床预后的相关性研究

The Study on the Correlation between Serum Soluble Triggering Receptor Expressed on Myeloid Cell-1 Level and Clinical Prognosis of Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

目的:研究血清可溶性髓样细胞触发受体-1(s TREM-1)水平与慢性阻塞性肺疾病急性加重期(AECOPD)患者临床预后的相关性关系。方法:122例AECOPD患者根据预后分为好转组(n=102)和恶化组(n=20),分别在入院当日、入院第3天及入院第7天采用酶联免疫吸附法检测两组患者血清s TREM-1、C反应蛋白(CRP)、降钙素原(PCT)表达水平,采用分析受试者工作特征曲线(receiver operating characteristic curve,ROC曲线)分析血清s TREM-1表达水平对AECOPD患者预后的价值,采用Pearson法分析血清s TREM-1表达水平与AECOPD患者28d病死率的相关性。结果:两组患者入院第3天及第7天血清s TREM-1、CRP及PCT表达水平均明显高于入院当日(P<0.05),相同时间点恶化组患者血清s TREM-1表达水平均明显高于好转组(P<0.05),而血清CRP及PCT表达水平比较无显著性差异(P>0.05),且好转组患者入院第7天血清s TREM-1表达水平较入院第3天明显降低(P<0.05);入院第3天血清s TREM-1水平检测对AECOPD患者28 d病死率的预测价值(AUC=0.846)优于入院当日(AUC=0.761)和入院第7天(AUC=0.675);入院当日、入院第3天及入院第7天血清s TREM-1水平与AECOPD患者28 d病死率呈正相关性关系(r1=0.612,r2=0.775,r3=0.563,P<0.05),入院第3天血清s TREM-1水平与AECOPD患者28 d病死率的相关性较入院当日和入院第7天更为密切。结论:血清s TREM-1水平与AECOPD临床预后有显著相关性,尤其是入院第3天检测血清s TREM-1水平对于AECOPD临床预后预测具有更重要的临床价值。

Objective To investigate the correlation between serum soluble triggering receptor expressed on myeloid cells-1(s TREM-1)level and clinical prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods 122 patients with AECOPD were divided into improvement group(n=102 cases)and death group(n=20 cases)according to their prognosis.The expression levels of serum s TREM-1,C-reactive protein(CRP)and procalcitonin(PCT)of the two groups were detected by enzyme-linked immunosorbent assay on the day of admission,the third day of admission and the seventh day of admission,respectively.Receiver operating characteristic curve(ROC curve)was used to analyze the prognostic value of serum s TREM-1 expression level in patients with AECOPD,and Pearson method was used to analyze the correlation between serum s TREM-1 expression level and the 28 d mortality of patients with AECOPD.Results The expression levels of serum s TREM-1,PCT and CRP of two groups on the third day and the seventh day of admission were significantly higher than those on the day of admission(P<0.05).At the same time,the expression level of serum s TREM-1 of death group was significantly higher than that of the improvement group(P<0.05).There was no significant difference in the expression levels of CRP and PCT between the deteriorated group and the improvement group(P>0.05).The serum s TREM-1 expression level of improvement group on the seventh day of admission was significantly lower than that on the third day of admission(P<0.05).The predictive value(AUC=0.846)of serum s TREM-1 level on the third day of admission for 28 d mortality of AECOPD patients was better than that on the first day of admission(AUC=0.761)and the seventh day of admission(AUC=0.675).There was a positive correlation between serum s TREM-1 level and 28 d mortality of AECOPD patients on the day of admission,the third day of admission and the seventh day of admission(r1=0.612,r2=0.775,r3=0.563,P<0.05).The correlation between serum s TREM-1 level and 28 d mortality of AECOPD patients on the third day of admission was closer than that on the day of admission and the seventh day of admission.Conclusion Serum s TREM-1 level is significantly correlated with the clinical prognosis of AECOPD.Especially on the third day of admission,the detection of serum s TREM-1 level has more important clinical value in predicting the clinical prognosis of AECOPD.