可溶性髓样细胞触发受体-1对严重多发伤患者早期感染的诊断价值  

Diagnostic value of soluble myeloid cells triggering receptor-1 early infection in severe multiple trauma patients

作　　者：赖剑波[1] 徐志康[1] 陈兴旺[1] 姚志军[1] 李健球[1] 陈少霖[1] 周华锋[1] 

机构地区：[1]广州医学院附属深圳沙井医院,广东深圳518104

出　　处：《中国现代医学杂志》2012年第7期64-68,共5页China Journal of Modern Medicine

基　　金：深圳市科技计划资助项目(No:201002150)

摘　　要：目的探讨可溶性髓样细胞触发受体-1(sTREM-1)对严重多发伤患者早期感染的诊断价值。方法应用双抗体夹心酶联免疫吸附实验(SELISA)测定72例ISS≥16分的多发伤患者伤后血清sTREM-1和降钙素原(PCT)含量,同时用免疫比浊法测定血清C反应蛋白(CRP)含量,并与30例健康对照比较,应用ROC曲线进行统计学处理。结果与健康对照组相比,所有多发伤患者sTREM-1、PCT和CRP伤后早期均出现不同水平升高;感染组患者感染前血清sTREM-1、PCT和CRP与非感染组相比无显著差异,待并发感染后则明显升高,其中以sTREM-1升高时间最早;sTREM-1、PCT和CRP的ROC曲线下面积分别为0.945、0.872和0.792,sTREM-1对感染并发症的诊断价值高于PCT和CRP。结论血清sTREM-1是严重多发伤患者早期感染并发症较好的辅助诊断指标,其诊断性能明显优于PCT和CRP。【Objective】 To evaluate the clinical significance of soluble triggering receptor expressed on myeloid cells-1（sTREM-1） in the diagnosis of early infection in the severe multiple trauma patients.【Methods】 sTREM-1 and procalcitonin（PCT） were measured by sandwich enzyme-linked immunosorbant assay（SELISA） and C reactive protein（CRP） was determined by inmmnoabsorbenc in serial samples of serum from 72 patients with severe multiple trauma（ISS≥16） and compared with those of 30 normal control volunteers.Patients were divided into 2 groups（infection and non-infection groups）.The differences of the above parameters between groups were compared.In addition,all data were managed by receiver operating characteristic（ROC）.【Results】 Compared with control group,serum levels of sTREM-1,PCT and CRP in the infection and non-infection groups were increased differently in the early posttrauma period.sTREM-1、PCT and CRP levels in the infection group were not significantly different from those in the non-infection group in the early posttrauma period before infection,but they increased significantly following infection.Serum level of sTREM-1 elevated earlier than those of PCT and CRP.Area under ROC curve of sTREM-1,PCT and CRP was 0.945,0.872 and 0.792 respectively.sTREM-1 has more diagnostic value than PCT and CRP for detection of infection after severe multiple trauma.【Conclusion】 The sTREM-1 is confirmed to be the sensitive and specific for detection of early infection after severe multiple trauma,and the sTREM-1 get the better of the PCT and CRP in the diagnostic peculiar performance.

关 键 词：多发伤 细胞因子 STREM-1 感染诊断 

分 类 号：R446.6[医药卫生—诊断学]