血清可溶性髓样细胞触发受体1在败血症诊断中的应用

摘要

目的 探讨败血症患者血清可溶性髓样细胞触发受体1(sTREM-1)的表达情况及其对败血症的诊断价值.方法 选取50例败血症患者作为败血症组,50例非败血症患者作为对照组.于患者入院第1天收集血清,采用定量酶联免疫吸附试验(ELISA)检测sTREM-1,采用电化学发光法测定降钙原素(PCT),采用免疫比浊法测定C反应蛋白(CRP),同时采集抗凝血检测白细胞(WBC)计数.采用受试者工作特征(ROC)曲线研究sTREM-1、PCT、CRP及WBC计数诊断败血症的效能.结果 败血症组的sTREM-1及PCT水平显著高于对照组(P<0.01).sTREM-1、PCT、CRP和WBC计数诊断败血症的ROC曲线的曲线下面积(AUC)分别为0.922、0.775、0.728和0.685.sTREM-1以212.25 ng/L为最佳截断点时诊断败血症的敏感性为0.84,特异性为0.90;PCT以0.475 ng/mL为最佳截断点时诊断败血症的敏感性为0.78,特异性为0.68.结论 sTREM-1诊断败血症具有较高的诊断效能,可作为败血症的早期诊断指标.%Objective To investigate the role of serum soluble triggering receptor expressed on myeloid cell-1 (sTREM-1) in the diagnosis of sepsis. Methods A total of 50 patients with sepsis were enrolled as sepsis group, and 50 patients with non-sepsis were enrolled as control group. Serum samples were collected at the 1st day of admission. The level of sTREM-1 was determined by quantitative enzyme-linked immunosorbent assay(ELISA). The level of procalcitonin(PCT) was determined by electro-chemiluminescence. The level of C-reactive protein (CRP) was determined by immunoturbidimetry. Meanwhile,anti-coagulated bloodwas collected for determining white blood cell(WBC) count.The efficiency of sTREM-1,PCT,CRP and WBC count for the diagnosis of sepsis was evaluated by receiver operating characteristic(ROC) curve. Results The levels of sTREM-1 and PCT in sepsis group were higher than those in control group(P<0.01). The areas under ROC curves(AUC) of sTREM-1,PCT,CRP and WBC count in the diagnosis of sepsis were 0.922,0.775,0.728 and 0.685,respectively. The optimal point of sTREM-1 for the diagnosis of sepsis was 212.25 ng/L,and the sensitivity and specificity were 0.84 and 0.90,respectively. The optimal point of PCT was 0.475 ng/mL,and the sensitivity and specificity were 0.78 and 0.68,respectively. Conclusions Serum sTREM-1 with high diagnosis efficiency can be used as an early indicator for the diagnosisof sepsis.