髓系细胞触发受体1在脓毒症诊断中的作用  

Association of triggering receptor expressed on myeloid cells(TREM-1)with the severity of sepsis

作　　者：江洁曙[1] 盖磊 方晶晶[1] 王珊珊[1] 李春仙[1] 

机构地区：[1]宁波大学医学院附属医院重症监护室,315000

出　　处：《浙江医学》2015年第14期1202-1204,共3页Zhejiang Medical Journal

摘　　要：目的探讨髓系细胞触发受体1(TREM-1)在脓毒症诊断及病情严重程度判断中的价值和意义。方法收集55例脓毒症患者(分为脓毒症组25例、严重脓毒症组24例、脓毒性休克组6例)及20例健康体检者(健康对照组)的外周静脉血标本,采用双抗体夹心ELISA法测定血清sTREM-1水平,用流式细胞术检测中性粒细胞和单核细胞膜表面TREM-1的表达。结果血清sTREM-1水平在脓毒性休克组[(250.0±10.9)pg/ml]>严重脓毒症组[(210.4±59.8)Pg/ml]>脓毒症组[(77.4±26.6)pg/ml]>对照组[(24.9±25.7)pg/ml],差异有统计学意义(P<0.05)。中性粒细胞表面TREM-1水平的表达脓毒性休克组(4.2±0.3)>严重脓毒症组(3.3±2.0)>脓毒症组(2.3±0.8)>对照组(1.6±1.5),差异有统计学意义(P<0.05);单核细胞表面TREM-1水平的表达脓毒性休克组(4.0±0.2)>严重脓毒症组(3.1±2.1)>脓毒症组(2.1±0.7)>对照组(1.5±1.3),差异有统计学意义(P<0.05)。患者外周血单核细胞及中性粒细胞膜表面TREM-1表达水平和血清sTREM-1水平均呈正相关(r=0.677、0.781,均P<0.05)。结论 TREM-1在脓毒症的发生、发展中起了至关重要的作用,血清sTREM-1水平测定对脓毒症的早期诊断和严重程度的评估具有指导价值。Objective To investigate the association of triggering receptor expressed on myeloid cells （TREM）-1 with the severity of sepsis. Methods Fifty five patients with sepsis were included in the study, including 25 cases of sepsis, 24 cases of severe sepsis and 6 cases of septic shock; and 20 healthy subjects served as controls. The peripheral blood sam- ples were collected and the serum levels of soluble TREM-1 （sTREM-1） were detected with double-antibody sandwich ELISA and the expression of TREM-1 on neutrophils and mononuclear cells were determined by flow cytometry. Results There was significant difference in serum sTREM-1 levels between patients with sepsis and health controls, sTREM-1 level in septic shock group（250.0 ± 10.9 pg/ml） was higher than that in severe sepsis group（210.4 ± 59.8 pg/ml）, sTREM-1 level was higher than that in sepsis group （77.4 ± 26.6 pg/ml）, and the latter was higher than that in control group （24.9 ± 25.7 pg/ml）（all P〈O.05）. The expression of TREM-1 on neutrophils and monocytes in septic shock group（4.2 ± 0.3 and 4.0 ± 0.2 ） was higher than that in se- vere sepsis group （3.3 ± 2.0 and 3.1 ±2.1） , the expression of TREM-1 in severe sepsis group was higher than that in sepsis group（2.3 ± 0.8 and 2.1±0.7）, and the latter was higher than that in control group（1.6 ± 1.5 and 1.5 ±1.3）, respectively （all P〈 0.05）. The TREM-1 expression on neutrophits and mononuclear ceils was positively correlated with serum levels of sTREM-1 （r=0.677 and 0.781, P〈0.05）. Conclusion Serum sTREM-1 levels and the expression of TREM-1 on peripheral neutrophils and monocytes are associated with the severity of sepsis, indicating that it might be of value in diagnosis of sepsis and evalua- tion of its severity.

关 键 词：脓毒症 髓系细胞触发受体-1 可溶性 

分 类 号：R459.7[医药卫生—急诊医学]