可溶性髓细胞表达触发受体1对肺炎诊断价值的初步评价  

Preliminary evaluation of soluble triggering receptor expressed on myeioid cells-I in diagnosis of pneumonia

作　　者：满晓燕[1] 童朝晖[1] 黄克武[1] 庞宝森[1] 詹庆元[1] 张隽[1] 

机构地区：[1]首都医科大学附属北京朝阳医院呼吸疾病研究所,100020

出　　处：《国际呼吸杂志》2009年第24期1473-1477,共5页International Journal of Respiration

摘　　要：目的探讨可溶性髓细胞表达触发受体1（solubletriggeringreceptorexpressedonmyeloidcells一1，sTREM一1）在感染性肺炎诊断中的价值及意义。方法应用固相酶联免疫吸附试验法检测42例感染性肺炎（简称肺炎）患者（重症肺炎27例，非重症肺炎患者15例）、19例非感染性间质性肺炎（简称间质性肺炎）患者和9名健康人（正常对照组）支气管肺泡灌洗液（bronchoaIveofar^avagefluid，BALF）及血浆中sTREM一1、肿瘤坏死因子α（TNF—α）、白介素1β（IL-1β）、IL一6的水平。结果①重症肺炎组及非重症肺炎组BALF中sTREM-1水平均高于正常对照组，（50．27±18．73）ng／L，（42．83±15．49）ng／I，vs（20．58±6．92）ng／L（P值均〈0．01）；间质性肺炎组BALF中sTREM-1水平[（22．77±5．90）ng／L]与正常对照组差异无统计学意义。②重症肺炎组血浆sTREM一1水平明显高于非重症肺炎组，（76．36±36．06）ng／Lvs（19．46土7．73）ng／L（P〈O．01）；非重症肺炎组血浆sTREM一1水平高于问质性肺炎组及正常对照组，（19．46±7．73）ng／LVS（3．42±1．89）ng／L，（3．53±1．53）ng／L（P值均〈0．01）。③BALF及血浆中TNF-α、IL一6水平均表现为重症肺炎组高于非重症肺炎组及间质性肺炎组（P值均〈0．01）；非重症肺炎组及间质性肺炎组均高于正常对照组（P值均〈0．05）。BALF中IL-1β水平在重症肺炎组、非重症肺炎组及间质性肺炎组均高于正常对照组（P〈0．05或P〈0．01）。结论sTREM～1可以作为感染性肺炎有意义的辅助诊断指标，并有可能协助判断感染的严重程度。Objective To investigate the role of soluble triggering receptor expressed on myeloid cells-1（sTREM-1）in the diagnosis of infectious pneumonia. Methods Forty-two patients with infectious pneumonia（including 27 severe pneumonia patients and 15 non-severe pneumonia patients）and 19 patients with noninfectious interstitial lung diseases（ILD） were enrolled in the study. Nine healthy volunteers were recruited as controls, sTREM-1, tumor necrosis factor-α （ TNF-α）, interleukin-1β （ IL-1β）, IL-6 in. bronchoalveolar lavage fluid （BALF）and plasma were measured by a solid-phase enzyme-linked immunosorbent assay. Results （1）sTREM-1 levels in BALF of severe pneumonia group and non-severe pneumonia group were higher than t hat in normal control group, （ 50. 27 ±18.73 ） ng/L, （ 42.83 ± 15.49 ） rig/L vs （20.58±6.92） ng/L（all P 〈0.01）. There was no statistical significance between ILD groupr（22.77±5.90） ng/L]and normal control group. （2）sTREM-1 level in plasma of severe pneumonia group was higher than that in non-severe pneumonia group, （76.36±36.06） ng/L vs （19.46± 7.73） ng/L（ P 〈0.01）. sTREM-1 level in plasma of non-severe pneumonia group was higher than that in ILD group and normal control group, （ 19.46 ± 7.73 ） ng/L vs （3.42 ± 1.89 ） ng/L, （3.58 ± 1.53 ） ng/L （ P 〈 0.01 ）. （2） TNF-α and IL-6 in BALF and plasma of severe pneumonia group were higher than those in non-severe pneumonia group and ILD group（all P 〈0.01）. TNF-α and IL-6 in BALF and plasma of non-severe pneumonia group and ILD group were higher than those in normal control group（all P 〈0.05）. IL-1β levels in BALF of severe pneumonia group, non-severe pneumonia group and ]LD group were higher than that in normal control group（ P 〈 0. 05 or P 〈 0.01 ）. Conclusions sTREM-1 can be a beneficial biomarker in the diagnosis of infectious pneumonia,and the assay of sTREM-1 in BALF and plasma can help evaluate＇the severity of infection.

关 键 词：可溶性髓细胞表达触发受体1 重症肺炎 间质性肺炎 支气管肺泡灌洗液 促炎症细胞因子 

分 类 号：R563.1[医药卫生—呼吸系统]