可溶性髓样细胞触发受体-1在慢性阻塞性肺疾病患者下呼吸道细菌感染中的诊断价值

摘要

Objective To explore the value of soluble triggering receptor expressed on myeloid cells-1(sTREM-1) in the diagnosis of bacterial lower respiratory tract infection in patients with an exacerbation of chronic obstructive pulmonary disease (COPD).Methods Serum levels of sTREM-1,PCT,CRP,and WBC count were detected in 52 patients in the exacerbation phase of COPD (group A) and in the stable phase of COPD (group B) after treatment.Quantitative sputum culture was performed in both groups.Group A were divided into infection group (group A1) and no bacteria infection group (group A2).30 healthy controls were enrolled as control group.The diagnostic value of ROC curve for sTREM-1 was studied.Results Serum levels of sTREM-1 and PCT in group A1 were higher than those in other groups.CRP level and WBC count were not significantly different among all the groups (P＞ 0.05).Serum levels ofsTREM-1,PCT,CRP,and WBC count in Group A2 were not significantly different from group B and control group (P ＞ 0.05).The area under the ROC curve of STREM-1 was 0.923,the sensitivity was 91.2％,and the specificity was 89.5％.Conclusion Serum sTREM-1 could be a better marker in the diagnosis of bacterial infection in patients with an exacerbation of COPD.%目的:探讨可溶性髓样细胞触发受体-1 (sTREM-1)在慢性阻塞性肺疾病(COPD)患者下呼吸道细菌感染中的诊断价值.方法:52例COPD患者,在急性加重期(A组)及在治疗达稳定期(B组)后测定其血清sTREM-1、降钙素原(PCT)、C反应蛋白(CRP)、白细胞计数(WBC),并行诱导痰细菌定量培养,A与B组作自身对照；以健康者30例作对照组,测定其上述炎症指标.将A组分为有致病菌感染组(A1组)及无感染组(A2组),应用ROC曲线研究sTREM-1的诊断效能.结果:A1组患者血清sTREM-1、PCT水平高于其他组,各组间CRP、WBC水平无明显差异(P＞0.05)；A2组与B组、对照组sTREM-1、PCT、CRP、WBC水平比较无明显差异(P＞ 0.05).sTREM-1的ROC曲线下面积为0.923,灵敏度为91.2％,特异度为89.5％.结论:血清sTREM-1是诊断急性加重期COPD患者下呼吸道细菌感染较好的标志物.