可溶性髓样细胞触发受体-1在化脓性关节炎诊断及疗效评价分析

Value of soluble triggering receptor expressed on myeloid cells-1 in diagnosis of suppurative arthritis and evaluation of curative effect

目的 分析可溶性髓样细胞触发受体-1(sTREM-1)在化脓性关节炎诊断及疗效评价中的价值,为感染性疾病诊断和治疗工作提供研究依据。方法 选取2015年2月-2017年2月医院收治的50例化脓性关节炎患者作为化脓性关节炎组,选取同期35例单纯骨关节炎患者作为骨关节炎组,选取同期30名健康体检者作为对照组。检测研究对象血液中sTREM-1、C-反应蛋白(CRP)、红细胞沉降率(ESR)水平,对化脓性关节炎组和骨关节炎组患者关节液中sTREM-1水平进行检测和比较;分析患者sTREM-1、CRP及ESR水平在化脓性关节炎诊断中的价值,观察化脓性关节炎组患者的临床疗效。结果 三组研究对象血液sTREM-1水平、血液CRP水平、ESR水平比较差异有统计学意义(P<0.05),其中化脓性关节炎组患者指标水平最高;化脓性关节炎组患者关节液sTREM-1水平为(82.05±62.97)ng/L高于骨关节炎组的(43.36±7.48)ng/L,两组比较差异有统计学意义(t=9.628,P<0.001);关节液sTREM-1、血液sTREM-1、CRP水平诊断化脓性关节炎患者的受试者工作特征曲线下面积(AUC)分别为0.913、0.841、0.785;关节液sTREM-1水平较低的化脓性关节炎患者的疗效分布优于关节液sTREM-1水平较高的患者(Z=2.260,P=0.024)。结论 化脓性关节炎表现为关节液和血液sTREM-1表达水平的上调,可作为诊断化脓性关节炎的辅助指导,术前检测关节液sTREM-1水平也有助于预测手术治疗的效果。

To analyze the value of soluble triggering receptor expressed on myeloid cells-1(sTREM- 1)in diagnosis of suppurative arthritis and evaluation of curative effect so as to provide guidance for clinical diagnosis and treatment of infectious diseases.METHODS Totally 50patients with suppurative arthritis who were treated in the hospital from Feb 2015to Feb 2017were assigned as the suppurative arthritis group,meanwhile,35patients with single osteoarthritis were chosen as the osteoarthritis group,and 30healthy people who received physical examination were set as the control group.The levels of serum sTREM-1,C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR)of the study objects were detected,the level of synovial fluid sTREM-1was detected and compared between the suppurative arthritis group and the osteoarthritis group.The values of sTREM-1, CRP and ESR in diagnosis of suppurative arthritis were analyzed,and the clinical curative effects of the patients with suppurative arthritic were observed.RESULTS There were significant differences in the levels of plasma sTREM-1,CRP and ESR among the three groups of study objects(P<0.05),the levels of the above indexes were the highest in the suppurative arthritis group.The synovial fluid sTREM-1level of the suppurative arthritis group was(82.05±62.97)ng/L,significantly higher than(43.36±7.48)ng/L of the osteoarthritis group(t= 9.628,P<0.001).The areas under receiver operating characteristic(ROC)curve of the synovial fluid sTREM-1, plasma sTREM-1and CRP were 0.913,0.841and 0.785,respectively.The curative effect of the suppurative arthritis patients with low level of synovial fluid sTREM-1was significantly better than that of the patients with high level of synovial fluid sTREM-1(Z=2.260,P=0.024).CONCLUSION The levels of expression of synovial fluid and plasma sTREM-1are upregulated in the patients with suppurative arthritis,which can be used for the auxiliary diagnosis of the suppurative arthritis,and the preoperative detection of the synovial fluid sTREM-1may facilitate the prediction of the curative effect.