髓系细胞触发受体-1在低水平降钙素原脓毒症患者的诊断意义  

The significance of triggering receptor expressed on myeloid cells-1 in the diagnosis of sepsis patients with primary low level of procalcitonin

作　　者：李英[1] 邓超[1] 计超[1] 向群[1] 殷宗宝[1] 

机构地区：[1]海口市人民医院重症医学科,海南海口570208

出　　处：《中国急救医学》2014年第2期132-134,共3页Chinese Journal of Critical Care Medicine

摘　　要：目的 探讨髓系细胞触发受体-1（TREM-1）在低水平降钙素原（PCT）脓毒症患者的诊断意义.方法 对2012-05~2012-12我院急诊科首次收治的脓毒症患者347例,采用免疫测定夹心法和最终荧光检测法进行血清TREM-1和PCT检测.结果 347例脓毒症患者血清TREM-1和PCT水平分别是（9.4±0.3）pg/mL和（10.6±0.8）ng/mL.其中104例脓毒症患者的PCT水平≥0.5～2.0 ng/mL,以PCT〉0.5 ng/mL为脓毒症诊断标准,其敏感度和特异度分别为84.2%、76.1%;如果104例脓毒症患者以TREM-1〉3.0 pg/mL为诊断标准,其敏感度和特异度分别为86.2%、90.3%,与PCT比较差异无统计学意义（P〉0.05）.两者联合检测,其敏感度和特异度分别为97.2%、94.7%.两者联合检测的敏感度分别与PCT和TREM-1比较差异有统计学意义（P〈0.05）;两者联合检测的特异度与PCT比较差异也有统计学意义（P〈0.05）,而与TREM-1比较则相反.结论 对于初次血清PCT水平在0.5～2.0 ng/mL的患者,应该检测TREM-1水平,两者联合检测可以提高脓毒症的诊断率.Objective To investigate the significance of triggering receptor expressed on myeloid cells - 1 （ TREM - 1 ） in diagnosing sepsis patients with primary low level of procalcitoniu （PCT）. Methods 347 firstly treated sepsis patients in the emergency department of our hospital from May 2012 - to December 2012 were detected serum TREM - 1 and PCT using immunoassay sandwich method and fluorescence. Results The serum levels of TREM - 1 and PCT in 347 eases of sepsis patients were （9.4 ± 0.3 ） pg/mL and （ 10.6 ± 0.8 ） ng/mL, respectively. Among 104 cases of sepsis patients whose PCT level was equal or greater than 0.5 ± 2.0 ng/mL, when PCT 〉 0.5 ng/mL was set up as the criteria for the diagnosis of sepsis, its sensitivity and specificity was 84.2%, 76. 1% , respectively. If TREM - 1 〉 3.0 pg/mL was set up as the diagnosis standard for these 104 cases, the sensitivity and specificity was 86.2%, 90.3% , respectively. There were no difference （ P 〉 0.05 ） between the two diagnosis criteria which was by PCT or by TREM. But when these two diagnosis criteria were combined, the sensitivity and the specificity was 97.2% and 94.7%, respectively, which was statistically significant （ P 〈 0.05 ） compared to PCT criteria. The sensitivity of combined detection was significant compared to TREM - 1 （ P 〈 0.05 ）, but the specificity was not difference （ P 〉 0.05 ）. Conclusion For the patients whose primary serum PCT levels were between 0.5 ng/mL and 2 ng/mL, we should detect their serum levels of TREM - 1, because the combined detection can improve the successful diagnosis rate of sepsis.

关 键 词：髓系细胞触发受体-1(TREM-1) 降钙素原(PCT) 脓毒症 

分 类 号：R446.113[医药卫生—诊断学]