【摘要】 目的研究血清中可溶性髓样细胞触发受体-1(s TREM-1)对危重症患者发生多器官功能障碍综合征(MODS)的预测价值。方法对86例危重症患者在入ICU 24 h内测定血浆中s TREM-1降钙素原(PCT)浓度,并记录其APACHEⅡ评分和SOFA评分。根据24 h后是否出现多器官功能障碍,把患者分为MODS组和非MODS组。应用受试者工作特征曲线(ROC)分析s TREM-1诊断MODS的敏感度与特异度。结果 MODS组血浆s TREM-1、PCT均显著高于非MODS组[s TREM-1(0.551±0.093)ng/L vs(0.292±0.059)ng/L,P<0.05;PCT(1.746±0.064)ng/L vs(1.586±0.046)ng/L,P<0.05]。血浆s TREM-1水平诊断多器官功能障碍综合征的ROC曲线下面积为0.77,以0.15 ng/L为诊断浓度阈值,s TREM-1早期诊断MODS的敏感性为100%,特异性为65.5%。结论检测血清s TREM-1对MODS的早期诊断有重要的临床意义。更多还原

【Abstract】 Objective To evaluate the predictive value of soluble triggering receptor expressed on myeloid cells-1(s TREM-1) concentrations in multiple organ dysfunction syndrome(MODS) in critical patients. Methods A total of 86 critically ill patients in ICU were selected in this study. The level of s TREM-1, procalcitonin(PCT) were examined within 24 hours after admission. All patients were scored by acute physiology and chronic health evaluationⅡ(APACHEⅡ) and sequential organ failure assessment(SOFA). According to whether multiple organ dysfunction occurred after 24 hours, patients were divided into multiple organ dysfunction group(MODS group) and non-multiple organ dysfunction group(non-MODS group). By the Receiver Operating Characteristic(ROC) analysis, sensitivity and specificity of each parameter were calculated. Results In patients with MODS, the s TREM-1 and PCT in plasma were significantly higher than those in the non-MODS group [s TREM-1:(0.551±0.093) ng/L vs(0.292±0.059) ng/L,P<0.05; PCT:(1.746±0.064) ng/L vs(1.586±0.046) ng/L, P<0.05]. By ROC analysis, the area under ROC curve of s TREM-1 was 0.77. The cut-off value of s TREM-1 in plasma were 0.15 ng/L, with sensitivity and specificity of100% and 65.5% respectively. Conclusion s TREM-1 is of great clinical significance in early diagnosis of multiple organ dysfunction syndrome.更多还原