Objective To investigate the relevance of the soluble triggering receptors expressed on myeloid cells-1 (sTREM-1) with multiple organ dysfunction syndrome (MODS) after severe multiple trauma. Methods A total of 93 patients with multiple trauma were divided into MODS and non-MODS groups. The MODS patients were individed into survival group and death group according to their prognosis. The peripheral serum concentrations of PCT, TNF-a and sTREM-1 were detected by enzyme-linked immunosorbent assay (ELISA) in patients and control group. ROC analysis was performed. Results Compared with control group, the serum levels of PCT, TNF-a and sTREM-1 in patients with multiple trauma were increased differently (P<0.01). The levels of PCT, TNF-a and sTREM-1 in MODS group were significantly higher than those in non-MODS group (P < 0. 01). Area under ROC curve of PCT, TNF-a and sTREM-1 were 0. 904, 0.687 and 0.907 respectively. The PCT and sTREM-1 levels in death group were higher than those in survival group (P < 0.01). The sensitivities and specificities of PCT, TNF-a and sTREM-1 were 80.0/79.3, 77.1/60.3 and 82.9/87.9 respectively. The correlation coefficients of sTREM-1 with PCT and TNF-a were 0.907 and 0.515 (P<0.05). Conclusion The sTREM-1 gets the better of the PCT and TNF-a in the diagnostic performance and in predicting the prognosis of MODS in patients with severe multiple trauma.%目的 探讨多发伤患者外周血血清降钙素原(PCT)、肿瘤坏死因子α(TNF-α)和可溶性髓样细胞触发受体-1(sTREM-1)与严重多发伤后多器官功能障碍综合征(MODS)的相关性.方法 93例多发伤患者按治疗过程中有无发生MODS分为MODS组和非MODS组.MODS患者按照其预后分为死亡组与存活组.采用ELISA法测定伤后及20例健康对照者的血清PCT、TNF-α及sTRME-1的含量,并应用受试者工作特征曲线(ROC曲线)进行统计学分析.结果 与对照组相比,多发伤患者血清PCT、TNF-α和sTREM-1伤后均出现不同程度的升高(P＜0.01)；MODS组与非MODS组比较,各项指标均有统计学差异(P＜0.01).PCT、TNF-α和sTREM-1的ROC曲线下面积分别为0.904、0.687和0.907.死亡组与存活组比较,PCT和sTREM-1水平存在统计学差异(P＜0.01),而TNF-α含量无差异(P＞0.05).PCT、TNF-α和sTREM-1诊断MODS的灵敏度分别为80.0％、77.1％、82.9％,特异性分别为79.3％、60.3％、87.9％.sTREM-1与PCT、TNF-α正相关(r分别为0.907、0.515,P均＜0.05).结论 sTREM-1对严重多发伤后预警MODS的诊断性能优于PCT和TNF-α,且对MODS的患者预后具有较好的预测价值.
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