Role of triggering receptor expressed on myeloid cells 1/2 in secondary injury after cerebral hemorrhage

Intracerebral hemorrhage(ICH)is a common severe emergency in neurosurgery,causing tremendous economic pressure on families and society and devastating effects on patients both physically and psychologically,especially among patients with poor functional outcomes.ICH is often accompanied by decreased consciousness and limb dysfunction.This seriously affects patients’ability to live independently.Although rapid advances in neurosurgery have greatly improved patient survival,there remains insufficient evidence that surgical treatment significantly improves long-term outcomes.With in-depth pathophysiological studies after ICH,increasing evidence has shown that secondary injury after ICH is related to long-term prognosis and that the key to secondary injury is various immune-mediated neuroinflammatory reactions after ICH.In basic and clinical studies of various systemic inflammatory diseases,triggering receptor expressed on myeloid cells 1/2(TREM-1/2),and the TREM receptor family is closely related to the inflammatory response.Various inflammatory diseases can be upregulated and downregulated through receptor intervention.How the TREM receptor functions after ICH,the types of results from intervention,and whether the outcomes can improve secondary brain injury and the long-term prognosis of patients are unknown.An analysis of relevant research results from basic and clinical trials revealed that the inhibition of TREM-1 and the activation of TREM-2 can alleviate the neuroinflammatory immune response,significantly improve the long-term prognosis of neurological function in patients with cerebral hemorrhage,and thus improve the ability of patients to live independently.

Relationships between genetic polymorphisms of triggering receptor expressed on myeloid cells-1 and septic shock in a Chinese Han population

BACKGROUND: Triggering receptor expressed on myeloid cells-1(TREM-1) is a cell surface receptor expressed on neutrophils and monocytes. TREM-1 acts to amplify infl ammation and serves as a critical mediator of infl ammatory response in the context of sepsis. To date, the predisposition of TREM-1 gene polymorphisms to septic shock has not been reported. This study was designed to investigate whether TREM-1 genomic variations are associated with the development of septic shock.METHODS: We genotyped two TREM-1 single nucleotide polymorphisms(SNPs, rs2234237 and rs2234246) and evaluated the relationships between these SNPs and septic shock on susceptibility and prognosis.RESULTS: TREM-1 rs2234246 A allele in the promoter region was signifi cantly associated with the susceptibility of septic shock in recessive model(AA, OR=3.10, 95%CI 1.15 to 8.32, P=0.02), and in codominant model(AG, OR=0.72, 95%CI 0.43–1.19, P=0.02; AA, OR=2.71, 95%CI 1.00–7.42; P=0.03). However, in three inherited models(dominant model, recessive model, and codominant model), none of the assayed loci was signif icantly associated with the prognosis of septic shock. The nonsurvivor group demonstrated higher plasma IL-6 levels(99.7±34.7 pg/mL vs. 61.2±26.5 pg/mL, P<0.01) than the survivor group. Plasma concentrations of IL-6 among the three genotypes of rs2234246 were AA 99.4±48.9 pg/m L, AG 85.4±43 pg/m L, and GG 65.3±30.7 pg/m L(P<0.01). The plasma concentrations of IL-6 in patients with AA genotypes were signifi cantly higher than those in patients with GG genotypes(P<0.01).CONCLUSION: TREM-1 genetic polymorphisms rs2234246 may be significantly correlated only with susceptibility to septic shock in the Chinese Han population.

Relationship between expression of triggering receptor-1 on myeloid cells in intestinal tissue and intestinal barrier dysfunction in severe acute pancreatitis

BACKGROUND：Triggering receptor expressed on myeloid cells-1 （TREM-1） in the intestine was upregulated and correlated with disease activity in inflammatory bowel diseases. Membrane- bound TREM-1 protein is increased in the pancreas, liver and kidneys of patients with severe acute pancreatitis （SAP）, suggesting that TREM-1 may act as an important mediator of inflammation and subsequent extra-pancreatic organ injury. This study aimed to investigate the relationship between the expression of TREM-1 in intestinal tissue and intestinal barrier dysfunction in SAP. METHODS： Sixty-four male Wistar rats were randomly divided into a sham operation group （SO group, n=32） and a SAP group （n=32）. A SAP model was established by retrograde injection of 5% sodium deoxycholate into the bile-pancreatic duct. Specimens were taken from blood and intestinal tissue 2, 6, 12, and 48 hours after operation respectively. The levels of D-lactate, diamine oxidase （DAO） and endotoxin in serum were measured using an improved spectro-photometric method. The expression levels of TREM-1, interleukin-1β （IL-1β）, and tumor necrosis factor-α （TNF-α） mRNA in terminal ileum were detected by real-time reverse transcription-polymerase chain reaction （RT-PCR）. Specimens of the distal ileum were taken to determine pathological changes by a validated histology score. The serum levels of D-lactate, DAO and endotoxin were significantly increased in each subgroup of SAP compared with the SO group （P〈0.01, P〈0.05）. The expression levels of TREM-1, IL-1β and TNF-a mRNA in the terminal ileum in each subgroup of SAP were significantly higher than those in the SO group （P〈0.01, P〈0.05）. The expression level of TREM-lmRNA was positively correlated with IL-1βand TNF-α mRNA （r=0.956, P=0.044; r=0.986, P=0.015）, but the correlation was not found between IL-1β mRNA and TNF-a mRNA （P=0.133）. Compared to the SO group, the pathological changes were aggravated significantly in the SAP group. CONCLUSIONS： The expression level of TREM-1 in intestinal tissue of rats with SAP was elevated, leading to the release of inflammatory mediators and intestinal mucosal injury. This finding indicates that TREM-I might play an important role in the development of intestinal barrier dysfunction in rats with SAP.

Soluble triggering receptor expressed on myeloid cell-1 （sTREM- 1）： a potential biomarker for the diagnosis of infectious diseases

Sensitive and useful biomarkers for the diagnosis and prognosis of infectious diseases have been widely developed. An example of these biomarkers is triggering receptor expressed on myeloid cell-1 （TREM-1）, which is a cell surface receptor expressed on monocytes/macrophages and neutrophils. TREM-1 amplifies inflammation by activating the TREM-1/DAP12 pathway. This pathway is triggered by the interaction of TREM-1 with ligands or stimulation by bacterial lipopolysaccharide. Consequently, pro-inflammatory cytokines and chemokines are secreted. Soluble TREM-1 （sTREM-1） is a special form of TREM-1 that can be directly tested in human body fluids and well-known biomarker for infectious diseases, sTREM-1 level can be potentially used for the early diagnosis and prognosis prediction of some infectious diseases, including infectious pleural effusion, lung infections, sepsis, bacterial meningitis, viral infections （e.g., Crimean Congo hemorrhagic fever and dengue fever）, fungal infections （e.g., Aspergillus infection）, and burn-related infections, sTREM-1 is a more sensitive and specific biomarker than traditional indices, such as C-reactive protein and procalcitonin levels, for these infectious diseases. Therefore, sTREM-1 is a feasible biomarker for the targeted therapy and rapid and early diagnosis of infectious diseases.

Soluble Triggering Receptor Expressed on Myeloid Cells-1 and Inflammatory Markers in Colorectal Cancer Surgery： A Prospective Cohort Study

Background： Major abdominal surgery, including colorectal cancer （CRC） surgery, leads to systemic inflammatory response syndrome that can be detected and monitored with inflammatory markers testing. The aims of the study were to evaluate the usefulness of soluble triggering receptor expressed on myeloid cells-l （sTREM-1 ）, interleukin-6 （IL-6）, procalcitonin （PCT）, and C-reactive protein （CRP） in following the inflammatory response in CRC surgery and postoperative period, as well as to determine if duration of the surgery and the time that the colon has been opened during the surgery （open colon time [OCT]） refect a larger surgical stress through inflammatory markers rise. Methods： The study included 20 patients who underwent CRC surgery and 19 healthy volunteers from June 2011 to September 2012. We determined inflammatory markers 1 day before surgery （T0）, 24 h （T1）, 48 h （T2）, and 7 days after the surgery （T3）. All statistical analyses were calculated using MedCalc Statistical Software version 14.8.1 （MedCalc Software bvba, Ostend, Belgium）. Results： Concentrations ofCRP, PCT, and I L-6 in all measurement times were statistically different and sTREM- 1 did not yield statistical significance. A weak positive correlation was/bund between l L-6 in T 1 and T2 with the duration of the surgery （T 1 ： r= 0.4060, P 〈 0.0001 ; T2：r =0.3430, P〈0.0001）andOCT（T1：r= 0.3640, P〈0.0001,T2：r=0.3430, P〈0.0001）.AweakpositivecorrelationbetweenCRP in T2 and OCT （r = 0.4210, P 〈 0.0001 ） was also found. The interconnectivity of tested parameters showed a weak positive correlation between CRP and IL-6 in T1 （r= 0.3680; P 〈 0.0001 ）, moderate positive correlation in T2 （r = 0.6770; P 〈 0.0001）, and a strong positive correlation in T3 （r = 0.8651; P 〈 0.0001）. Conclusions： CRP, IL-6, and PCT were shown to be reliable for postoperative monitoring. Simultaneous determination of CRP and IL-6 might not be useful as they follow similar kinetics, sTREM- 1 might not be useful in CRC postoperative monitoring.

Role of Triggering Receptor Expressed on Myeloid Cell-1 Expression in Mammalian Target of Rapamycin Modulation of CD8＋ T-cell Differentiation during the Immune Response to Invasive Pulmonary Aspergillosis

Background： Triggering receptor expressed on myeloid cell- 1 （TREM- 1） may play a vital role in mammalian target ofrapamycin （mTOR） modulation ofCD8＋ T-cell differentiation through the transcription factors T-box expressed in T-cells and eomesodermin during the immune response to invasive pulmonary aspergillosis （IPA）. This study aimed to investigate whether the roTOR signaling pathway modulates the proliferation and differentiation of CD8＋ T-cells during the immune response to I PA and the role TREM-1 plays in this process. Methods： Cyclophosphamide （CTX） was injected intraperitoneally, and Asl？e;gillus.[mnigams spore suspension was inoculated intranasally to establish the immunosuppressed IPA mouse model. After inoculation, rapamycin （2 mg-kg ·d -1） or interleukin （IL）-12 （5 μg/kg every other day） was given for 7 days. The number of CD8＋ effector memory T-cells （Tern）, expression of interferon （IFN）-y, roTOR, and ribosomal protein $6 kinase （S6K）, and the levels of IL-6, IL- 10, galactomannan （GM）, and soluble TREM- 1 （sTREM-I） were measured. Results： Viable A. fumigatus was cultured from the lung tissue of the inoculated mice. Histological examination indicated greater inflammation, hemorrhage, and lung tissue injury in both IPA and CTX ＋ IPA mice groups. The expression of mTOR and S6K was significantly increased in the CTX ＋ IPA ＋ I L- 12 group compared with the control, I PA （P = 0.01 ; P - 0.001 ）, and CTX ＋ 1PA （P = 0.034; P = 0.032） groups, but significantly decreased in the CTX ＋ IPA ＋ RAPA group （P 〈 0.001 ）. Compared with the CTX ＋ IPA group, the proportion of Tern, expression of IFN-y, and the level ofsTREM-I were significantly higher after IL-12 treatment （P = 0.024, P = 0.032, and P = 0.017, respectively）, and the opposite results were observed when the roTOR pathway was blocked by rapamycin （P 〈 0.001）. Compared with the CTX ＋ I PA and CTX ＋ I PA ＋ RAPA groups, IL-12 treatment increased IL-6 and downregulated IL- 10 as well as G M, which strengthened the immune response to the IPA infection. Conclusions： mTOR modulates CD8＋ T-cell differentiation during the immune response to IPA. TREM-1 may play a vital role in signal transduction between mTOR and the downstream immune response.

The triggering receptor expressed on myeloid cells 2-apolipoprotein E signaling pathway in diseases

Triggering receptor expressed on myeloid cells 2(TREM2)is a membrane receptor on myeloid cells and plays an important role in the body’s immune defense.Recently,TREM2 has received extensive attention from researchers,and its activity has been found in Alzheimer’s disease,neuroinflammation,and traumatic brain injury.The appearance of TREM2 is usually accompanied by changes in apolipoprotein E(ApoE),and there has been a lot of research into their structure,as well as the interaction mode and signal pathways involved in them.As two molecules with broad and important roles in the human body,understanding their correlation may provide therapeutic targets for certain diseases.In this article,we reviewed several diseases in which TREM2 and ApoE are synergistically involved in the development.We further discussed the positive or negative effects of the TREM2-ApoE pathway on nervous system immunity and inflammation.

温肾通督方促进小鼠脊髓损伤的修复

背景:前期研究证实,温肾通督方可通过抑制脾脏B细胞焦亡、促进微血管内皮细胞吞噬髓鞘碎片、影响小胶质细胞迁移和浸润、促进受损神经元恢复、降低脊髓损伤后神经元凋亡等促进脊髓损伤恢复,但其机制尚不明确。目的:探讨温肾通督方对脊髓损伤小鼠髓系细胞触发受体2(triggering receptor expressed on myeloid cells 2,TREM2)及PI3K/Akt信号通路的影响。方法:取36只C57BL/6小鼠,采用随机数字表法分为假手术组、模型组、温肾通督方组,每组12只。模型组与温肾通督方组采用改良Allen’s法制备小鼠T10脊髓损伤模型,造模后第1天,温肾通督方组灌胃给予温肾通督方,假手术组、模型组灌胃给予生理盐水,每天1次,连续给药28 d。给药期间,通过BMS评分和斜板实验评价各组小鼠运动功能;造模后第7,28天,采用苏木精-伊红染色观察各组小鼠脊髓组织病理变化,免疫荧光染色双标法检测脊髓组织离子化钙结合适配分子1(ionized calcium binding adaptor molecule 1,IBA1)、TREM2蛋白表达,Western blot检测脊髓组织TREM2、PI3K、p-PI3K、Akt、p-Akt、Bcl2、Bax、Caspase3蛋白表达。结果与结论:①BMS评分和斜板实验结果表明,脊髓损伤造模后小鼠后肢运动功能下降,而经过温肾通督方治疗后,脊髓损伤小鼠后肢运动功能明显提升。②苏木精-伊红染色结果显示,与模型组比较,温肾通督方小鼠脊髓组织病理结构明显改善,表现为背侧白质和神经元萎缩程度、细胞质空泡化降低及炎性细胞浸润减少等。③免疫荧光染色结果显示,造模后第7天,模型组IBA1、TREM2蛋白表达均低于假手术组(P<0.05),温肾通督方组IBA1、TREM2蛋白表达均高于模型组(P<0.05);造模后第28天,模型组TREM2蛋白表达低于假手术组(P<0.05),温肾通督方组小鼠脊髓组织中的TREM2蛋白表达高于模型组(P<0.05)。④Western blot检测结果表明,造模后第7天,与假手术组相比,模型组TREM2、Akt蛋白表达及Bcl2/Bax比值降低(P<0.05),p-Akt、Bax蛋白表达及p-Akt/Akt比值升高(P<0.05);与模型组相比,温肾通督方组TREM2、PI3K、p-PI3K、Akt、p-Akt、Bcl2蛋白表达及p-PI3K/PI3K、p-Akt/Ak、Bcl2/Bax比值升高(P<0.05),Bax、Caspase3蛋白表达降低(P<0.05)。造模后第28天,与假手术组相比,模型组TREM2、PI3K、p-PI3K、Akt、p-Akt、Bcl2蛋白表达及Bcl2/Bax比值降低(P<0.05),Bax蛋白表达升高(P<0.05);与模型组相比,温肾通督方组TREM2、PI3K、Akt、p-Akt、Bcl2蛋白表达及Bcl2/Bax比值升高(P<0.05),Bax蛋白表达降低(P<0.05)。⑤结果表明,温肾通督方可能通过上调小胶质细胞TREM2激活PI3K/Akt信号通路,抑制神经元凋亡发挥神经保护作用,进而促进脊髓损伤的修复。

TREM-1 expression in rat corneal epithelium with Aspergillus fumigatus infection

AIM: To investigate the expression of triggering receptor expressed on myeloid cells-1(TREM-1) in the aberrant inflammation within the corneal epithelium at early period of fungal infection.METHODS: A total of 65 Wistar rats were randomly divided into control group, sham group and fungal keratitis(FK) group, in which the cornea was infected by Aspergillus fumigatus(A. fumigatus). After executed randomly at 8, 16, 24, 48 and 72 h after experimental model being established, the severity of keratomycosis in rats was scored visually with the aid of a dissecting microscope and slit lamp. Then corneas in three groups were collected to assess the expression of TREM-1through quantitative reverse transcription-polymerase chain reaction(RT-PCR), immunofluorescence technique and Western blot analysis. The correlation between FK inflammation and expression of TREM-1 was also analyzed.RESULTS: Corneal inflammation scores increased with time after fungal infection(F =49.74, P =0.000). The inflammation scores in FK group were obviously higher than those in sham group on the whole(F =137.78, P =0.000). Levels of TREM-1 in the infected rat corneal epithelium had elevated at 8h and peaked at 48h(P 【0.001,compared with control group). Western blot analysis also showed an obviously elevated TREM-1 level in rat corneal epithelium at 24 h and 48 h after fungal infection.Immunofluorescence technique showed that TREM-1mainly existed in corneal epithelium and infected corneal stoma of rat. TREM-1 protein expression was enhanced after fungal infection. Moreover, severity of FK inflammation was significantly related to TREM-1expression in FK(r =0.942, P =0.000).CONCLUSION: TREM-1 may contribute to amplify theinflammation in the cornea infected with A. fumigatus and play critical roles in the battle against A. fumigatus in the innate immune responses.

丹红注射液联合肝素治疗脓毒症并发急性肾损伤的效果

目的探讨丹红注射液联合肝素治疗脓毒症并发急性肾损伤的临床疗效及对血清高迁移率族蛋白B1(high mobility group box 1,HMGB1)和可溶性髓样细胞触发受体-1(soluble triggering receptor expressed on myeloid cells-1,sTREM-1)水平的影响。方法选取收治的80例脓毒症并发急性肾损伤患者作为研究对象,用随机数字表法分为2组,每组40例,2组均予以常规治疗,对照组加用低分子肝素,观察组加用低分子肝素和丹红注射液。对比2组的治疗效果,记录2组治疗前后的血清HMGB1、sTREM-1、肾功能指标及凝血功能指标等的变化。结果与治疗前比较,2组治疗后的各项生命指标、炎症指标、凝血功能指标、肾功能指标、HMGB1及sTREM-1水平均得到明显改善(P<0.05)。与对照组比较,观察组治疗后的体温、心率及急性生理学及慢性健康状况评分系统Ⅱ(acute physiology and chronic health evaluationⅡ,APACHEⅡ)评分均明显更低,血清白细胞介素-6(interleutin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、C反应蛋白(C-reactive protein,CRP)、降钙素原(procall⁃citonin,PCT)、血肌酐(screatinine,Scr)、胱抑素C(cystatin C,CysC)、尿素氮(blood urea nitrogen,BUN)、纤维蛋白原(fibrinogen,FIB)及D-二聚体(D-dimer,D-D)的水平均更低,机械通气时间及ICU住院时间明显更短,凝血酶原时间(prothrombin time,PT)明显更长(P<0.05)。2组治疗后的存活率比较差异无统计学意义(P>0.05)。结论丹红注射液联合肝素治疗能够通过抑制sTREM-1、HMGB1的表达,减轻炎症反应,改善凝血功能,增大肾灌注,减轻肾组织损伤,从而治疗脓毒症并发急性肾损伤。

脓毒症患者血清HMGB1、sTLT-1、NLR变化及其对并发急性肺损伤的预测价值

目的探讨脓毒症患者血清高迁移率族蛋白B1(HMGB1)、可溶性髓样细胞触发受体样转录因子-1(sTLT-1)、中性粒细胞/淋巴细胞比值(NLR)变化及其对并发急性肺损伤(ALI)的预测价值。方法回顾性分析2022年1月至2023年12月新乡医学院第一附属医院收治的120例脓毒症患者的临床资料,根据住院期间是否发生ALI分为ALI组35例、非ALI组85例。比较ALI组与非ALI组、ALI组不同病情程度患者血清HMGB1、sTLT-1、NLR水平,并采用受试者工作(ROC)曲线分析血清HMGB1、sTLT-1、NLR对脓毒症并发ALI的预测价值。结果ALI组患者的血清HMGB1、sTLT-1、NLR水平分别为(74.21±11.70)pg/mL、(593.06±82.45)pg/mL、5.13±1.16,明显高于非ALI组的(60.15±7.95)pg/mL、(525.73±54.84)pg/mL、4.08±0.64,差异均有统计学意义(P<0.05);ALI组中,高危组患者的血清HMGB1、sTLT-1、NLR水平分别为(86.43±5.90)pg/mL、(686.31±23.91)pg/mL、(6.49±1.11),明显高于中危组的(76.64±11.44)pg/mL、(599.28±88.40)pg/mL、5.27±1.00及低危组的(64.48±5.06)pg/mL、(539.93±35.90)pg/mL、4.27±0.71,且中危组患者均高于低危组,差异均有统计学意义(P<0.05);血清HMGB1、sTLT-1、NLR联合预测脓毒症并发ALI的曲线下面积(AUC)、敏感度、特异度分别为0.890、90.60%、92.10%,HMGB1单独检测分别为0.848、84.70%、77.10%,sTLT-1单独检测分别为0.732、71.40%、68.20%,NLR单独检测分别为0.785、62.90%、84.20%,联合检测高于各指标单独检测(P<0.05)。结论脓毒症并发ALI患者血清HMGB1、sTLT-1、NLR明显升高,且三者联合检测对并发ALI有较高的预测价值。

血清sTREM-1联合降钙素原对老年胆道结石术后继发急性胆管炎的预测价值

目的 探讨联合检测血清可溶性髓系细胞触发受体-1(sTREM-1)和降钙素原(PCT)对老年胆道结石术后继发急性胆管炎(AC)的预测价值。方法 以2019年1月至2022年9月收治的145例行胆道结石术的老年病人作为研究对象,按术后是否继发AC将病人分为对照组(未继发AC,n=56)和观察组(继发AC,n=89),再根据AC病情程度将观察组病人分为轻度(n=37)、中度(n=29)和重度(n=23)3个亚组。检测各组病人血清WBC、CRP、PCT和sTREM-1水平并进行比较。采用Logistic回归分析继发AC以及AC严重程度的影响因素;绘制ROC曲线分析PCT和sTREM-1水平对老年胆道结石术后继发AC的预测效能。结果 与对照组比较,观察组血清WBC、CRP、PCT和sTREM-1水平显著升高(P<0.01)。与轻度组比较,中度组和重度组病人血清CRP、PCT和sTREM-1水平均显著升高;与中度组比较,重度组病人血清WBC和PCT水平显著升高(均P<0.05)。Logistic回归分析结果显示,血清CRP、PCT和sTREM-1水平升高是老年胆道结石术后继发AC和AC重症的独立危险因素(均P<0.05)。ROC曲线评估结果显示,血清PCT和sTREM-1联合检测对术后继发AC以及AC严重程度的预测效能均显著高于单一指标(均P<0.05)。结论 胆道结石术后继发AC的老年病人血清PCT和sTREM-1水平明显升高,二者联合检测对胆道结石术后继发AC具有预测价值。

急性脑出血患者血清VILIP-1、sTREM-1水平变化及其与神经功能缺损程度和预后的关系

目的探讨急性脑出血(ACH)患者血清视锥蛋白样蛋白-1(VILIP-1)、可溶性髓系细胞触发受体-1(sTREM-1)水平变化及其与神经功能缺损程度和预后的相关性。方法选取2021年1月至2023年1月该院收治的115例ACH患者为ACH组,另选取同期在该院体检的115例健康志愿者作为对照组。根据美国国立卫生研究院卒中量表(NIHSS)评估的神经功能缺损程度将ACH患者分为轻度缺损组(39例)、中度缺损组(46例)、重度缺损组(30例)。随访90 d,根据改良Rankin量表评估的预后将ACH患者分为预后不良组(27例)和预后良好组(88例)。采用酶联免疫吸附试验检测血清VILIP-1、sTREM-1水平。通过Spearman相关性分析ACH患者NIHSS评分与血清VILIP-1、sTREM-1水平的相关性,建立多因素Logistic回归模型分析影响ACH患者预后的因素,绘制受试者工作特征(ROC)曲线分析血清VILIP-1、sTREM-1水平对ACH患者预后不良的预测价值。结果与对照组相比,ACH组血清VILIP-1、sTREM-1水平升高(P<0.05)。轻度缺损组、中度缺损组、重度缺损组血清VILIP-1、sTREM-1水平依次升高(P<0.05)。Spearman相关性分析结果显示,ACH患者NIHSS评分与血清VILIP-1、sTREM-1水平呈正相关(r=0.792、0.781,均P<0.001)。随访90 d,115例ACH患者预后不良发生率为23.48%(27/115)。多因素Logistic回归分析显示,血肿体积增加和NIHSS评分、VILIP-1、sTREM-1升高为影响ACH患者预后的独立危险因素(P<0.05)。ROC曲线分析显示,血清VILIP-1、sTREM-1水平联合预测ACH患者预后不良的曲线下面积为0.872,大于血清VILIP-1、sTREM-1水平单独预测的0.784、0.772(P<0.05)。结论ACH患者血清VILIP-1、sTREM-1水平升高,与神经功能缺损程度加重和预后不良密切相关,血清VILIP-1、sTREM-1水平联合检测对ACH患者预后不良具有较高的预测价值。

急性胆囊炎患者胆囊切除术后血清CCK-8、TREM1水平与发生感染的关系

目的分析急性胆囊炎(AC)患者胆囊切除术后血清胆囊收缩素-8(CCK-8)、髓系细胞触发受体1(TREM1)水平与发生感染的关系。方法将该院2020年12月至2022年12月收治的70例胆囊切除术后发生感染的AC患者纳入研究组,66例胆囊切除术后未发生感染的AC患者纳入对照组。采用酶联免疫吸附试验检测血清CCK-8、TREM1水平。采用Pearson相关分析胆囊切除术后发生感染AC患者血清中CCK-8、TREM1水平与炎症因子水平的相关性。采用受试者工作特征(ROC)曲线分析血清CCK-8、TREM1水平对AC患者胆囊切除术后发生感染的诊断价值。采用多因素Logistic回归分析AC患者胆囊切除术后感染的影响因素。结果研究组与对照组有胆囊结石、胆囊周边积液比例比较,差异均有统计学意义(P<0.05)。与对照组比较,研究组血清CCK-8水平明显降低,TREM1水平明显升高,差异均有统计学意义(P<0.05)。研究组C反应蛋白(CRP)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)水平明显高于对照组,差异均有统计学意义(P<0.05)。胆囊切除术后发生感染的AC患者血清CCK-8水平与CRP、IL-8、TNF-α水平均呈负相关(P<0.05),TREM1水平与CRP、IL-8、TNF-α水平均呈正相关(P<0.05)。ROC曲线分析显示,血清CCK-8与TREM1联合检测诊断AC患者胆囊切除术后发生感染的曲线下面积(AUC)明显大于CCK-8、TREM1单独检测的AUC(Z=5.703,P<0.001;Z=4.584,P<0.001)。有胆囊结石、胆囊周边积液及血清CCK-8水平降低、血清TREM1水平升高均为AC患者胆囊切除术后发生感染的危险因素(P<0.05)。结论胆囊切除术后发生感染的AC患者血清CCK-8水平降低,TREM1水平升高,二者联合检测能够提高对AC患者胆囊切除术后发生感染的诊断价值。

血清sTLT-1、SP-D、NF-κB水平在脓毒症急性肺损伤预后评估中的价值

目的 探究血清可溶性髓样细胞触发受体样转录因子-1(sTLT-1)、表面活性蛋白-D(SP-D)、核转录因子-κB(NF-κB)水平在脓毒症急性肺损伤(ALI)预后评估中的价值。方法 选择2021年4月—2023年4月来我院就诊脓毒症患者36例作为脓毒症组,选择同期脓毒症并ALI患者80例作为ALI组。比较两组的一般资料、血清sTLT-1、SP-D、NF-κB水平、APACHEⅡ评分、LIPS评分。ALI组患者根据1个月内生存情况,分为死亡组(n=32)和存活组(n=48)。比较死亡组和存活组的一般资料、血清sTLT-1、SP-D、NF-κB水平、APACHEⅡ评分、LIPS评分,分析ALI组预后不良的影响因素及血清学sTLT-1、SP-D、NF-κB指标对ALI预后评估价值。结果 ALI组患者的sTLT-1、SP-D、NF-κB、APACHEⅡ评分、LIPS评分均高于脓毒症组(P<0.05);单因素分析结果显示,ALI患者中死亡组及存活组的性别、年龄、感染部位、吸烟例数及BMI水平比较,差异无统计学意义(P>0.05);ALI患者中死亡组血清sTLT-1、SP-D、NF-κB、APACHEⅡ评分、LIPS评分均高于存活组(P<0.05);多因素分析显示,血清sTLT-1、SP-D、NF-κB、APACHEⅡ评分、LIPS评分是ALI患者预后不良的独立危险因素;采用ROC曲线分析,sTLT-1、SP-D、NF-κB联合诊断ALI预后不良的AUC为0.914,均高于单一sTLT-1、SP-D、NF-κB的0.832、0.796、0.816。结论 血清sTLT-1、SP-D、NF-κB水平与脓毒症ALI的发生及发展相关,同时是其预后不良的独立危险因素,临床联合检测sTLT-1、SP-D、NF-κB三项指标有助于指导ALI预后评估。

血清可溶性髓系细胞触发性受体1、白细胞介素-21、25羟基维生素D在炎症性肠病患儿中的表达及相关性

目的探讨血清可溶性髓系细胞触发性受体1(sTREM-1)、白细胞介素-21(IL-21)、25羟基维生素D[25(OH)D]在炎症性肠病患儿中的表达及相关性。方法选取107例炎症性肠病患儿纳入观察组,另选取同期53例健康体检儿童纳入对照组,依照疾病活动性将观察组患儿分为活动期组54例和缓解期组53例,分别比较观察组与对照组、活动期组与缓解期组sTREM-1、IL-21、25(OH)D表达水平,采用Kendall's tau-b法分析sTREM-1、IL-21、25(OH)D与炎症性肠病活动性的相关性;采用受试者工作特征(ROC)曲线分析sTREM-1、IL-21、25(OH)D诊断炎症性肠病和预测炎症性肠病活动期的曲线下面积(AUC)、敏感度、特异度。结果观察组血清sTREM-1、IL-21水平高于对照组,25(OH)D水平低于对照组,差异有统计学意义(P<0.05)。活动期组血清sTREM-1、IL-21水平高于缓解期组,25(OH)D水平低于缓解期组,差异有统计学意义(P<0.05)。Kendall′s tau-b相关性分析显示,sTREM-1、IL-21与炎症性肠病活动性呈正相关(r=0.460、0.484,P<0.05),25(OH)D与炎症性肠病活动性呈负相关(r=-0.434,P<0.05)。ROC曲线显示,sTREM-1、IL-21、25(OH)D和三者联合诊断炎症性肠病的AUC分别为0.791、0.852、0.808和0.862,敏感度分别为74.80%、81.30%、75.50%和81.30%,特异度分别为75.50%、75.50%、81.30%和79.20%;sTREM-1、IL-21、25(OH)D和三者联合预测炎症性肠病活动期的AUC分别为0.821、0.840、0.799和0.840,敏感度分别为79.60%、75.90%、77.40%和87.00%,特异度分别为79.20%、75.50%、83.30%和79.20%。结论血清sTREM-1、IL-21、25(OH)D水平与儿童炎症性肠病的发生与发展密切关联,动态监测其水平有助于为临床诊断炎症性肠病和评估患儿病情进展提供重要参考依据。

联合检测血清高迁移率族蛋白B1、可溶性髓系细胞触发受体-1对脓毒症并发急性肾损伤有预测价值

目的:探究联合检测血清高迁移率族蛋白B1(HMGB1)、可溶性髓系细胞触发受体-1(sTREM-1)对脓毒症并发急性肾损伤(AKI)的诊断价值。方法:选取120例脓毒症患者,分为AKI组47例与非AKI组73例。采用酶联免疫吸附法(ELISA)检测2组血清肌酐、C反应蛋白、胱抑素C、HMGB1、sTREM-1水平;检测2组血清白细胞计数、血红蛋白水平;采用分光光度法检测2组乳酸水平;使用免疫比浊法检测2组白蛋白水平。2组均进行序贯器官衰竭评分(SOFA)、急性生理与慢性健康状况评估(APACHEⅡ)评分。比较2组以上指标,采用单因素分析和多因素Logistic回归分析脓毒症患者并发AKI的独立影响因素。绘制受试者工作特征(ROC)曲线,评估各指标对预后的预测价值。结果:血肌酐、胱抑素C、乳酸、HMGB1、sTREM-1水平、SOFA评分、APACHEⅡ评分为脓毒症患者并发AKI的独立危险因素(P均<0.05)。HMGB1联合sTREM-1诊断脓毒症AKI的ROC曲线下面积(AUC)为0.879,优于HMGB1、sTREM-1单独诊断(AUC分别为0.778、0.823)。结论:血清HMGB1、sTREM-1是脓毒症患者并发AKI的独立危险因素,联合检测HMGB1、sTREM-1对于诊断脓毒症并发AKI的价值优于单独检测,可作为评估该类患者病情的敏感指标。

血清Kal、TREM-1对高血压性脑出血患者病情严重程度及预后的影响

目的探讨血清人源性激肽释放酶结合蛋白(Kal)、髓系细胞触发受体-1(TREM-1)对高血压性脑出血(HICH)患者病情严重程度及预后的影响。方法选取该院2020年1月至2023年3月该院收治的180例HICH患者作为HICH组,另选取同期在该院体检的180例健康体检者作为对照组。根据HICH患者的病情严重程度分为轻度组、中度组、重度组,根据患者的预后情况分为预后良好组和预后不良组。收集HICH患者基本资料并检测所有研究对象的Kal、TREM-1水平。采用多因素Logistic回归分析HICH患者预后不良的危险因素,绘制受试者工作特征(ROC)曲线分析血清Kal、TREM-1对HICH患者预后不良的预测价值。结果HICH组血清Kal水平低于对照组,TREM-1水平高于对照组(P<0.05)。轻度组有56例患者,中度组有82例患者,重度组有42例患者。重度组血清Kal水平低于轻度组和中度组,且中度组低于轻度组(P<0.05)。重度组血清TREM-1水平高于轻度组和中度组,且中度组高于轻度组(P<0.05)。预后良好组有122例患者,预后不良组有58例患者。预后不良组有高血压史患者的比例、TREM-1水平、出血量均高于预后良好组,Kal水平低于预后良好组(P<0.05);预后良好组和预后不良组年龄、男性比例、体质量指数、糖尿病史情况比较,差异均无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,有高血压史、TREM-1水平升高、出血量大、Kal水平降低是HICH患者预后不良的独立危险因素(P<0.05)。ROC曲线分析结果显示,2项指标联合检测预测HICH患者预后不良的曲线下面积为0.920,高于Kal、TREM-1单独预测的0.857和0.860(Z=2.765、2.324,P=0.006、0.020)。结论HICH患者血清Kal水平降低,TREM-1水平升高,与患者病情严重程度及预后密切相关,2项指标联合检测对HICH患者预后不良具有较高预测价值。

黄芪续命汤对缺血性脑卒中致血管性痴呆患者的临床疗效观察

[目的]探讨黄芪续命汤对缺血性脑卒中致血管性痴呆(VD)患者认知功能及血清可溶性髓样细胞触发受体2(sTREM2)、脂蛋白相关磷酸酶A2(Lp-PLA2)和β淀粉样蛋白1-42(Aβ1-42)的影响。[方法]选取南阳市第二人民医院于2020年1月—2022年8月收治的缺血性脑卒中致血管性痴呆患者110例,采用随机数字表法分为对照组与观察组,观察组54例,对照组53例。对照组均接受单纯常规西医治疗,观察组在对照组的基础上加用黄芪续命汤治疗,两组均持续治疗1个月。对比两组患者临床疗效及治疗前后中医证候积分、蒙特利尔认知评价量表(MoCA)各项评分、简易智力状态检查量表(MMSE)评分、美国国立卫生院卒中量表(NIHSS)评分、长谷川痴呆量表(HDS)评分、血清sTREM2、Lp-PLA2和Aβ1-42水平变化情况,比较两组患者治疗期间不良反应发生情况。[结果]两组患者临床疗效对比结果显示,观察组治疗总有效率为92.59%,明显高于对照组的77.36%(P<0.05)。治疗后两组患者主症状积分、次症状积分及总积分均明显下降(P<0.05),且观察组上述指标均明显小于对照组(P<0.05)。治疗后两组患者MoCA各项评分均有明显提升(P<0.05),且观察组MoCA各项评分均明显高于对照组(P<0.05)。治疗后两组患者MMSE、NIHSS、HDS评分均有明显改善(P<0.05),且观察组上述评分的改善程度均明显优于对照组(P<0.05)。治疗后两组患者血清sTREM2、Lp-PLA2和Aβ1-42水平均有明显下降(P<0.05),且观察组上述血清指标均明显低于对照组(P<0.05)。观察组与对照组治疗期间不良反应的总发生率分别为5.56%(3/54)、9.43%(5/53),组间比较差异无统计学意义(P>0.05)。[结论]黄芪续命汤对缺血性脑卒中致血管性痴呆患者的临床疗效确切,可使患者认知功能及血清sTREM2、Lp-PLA2和Aβ1-42水平得到明显改善,且不会增加用药风险,值得临床推广应用。