sTREM-1联合免疫检测对老年重症肺炎糖皮质治疗后短期转归的预测价值  

Predictive Value of sTREM-1 Combined Immunoassay for Short-term Prognosis of Senile Severe Pneumonia after Glucocorticoid Treatment

作　　者：谭楠[1] 赵宁 赵昆[1] 陈凯[2] TAN Nan;ZHAO Ning;ZHAO Kun(The First Hospital of Xi＇an,Shaanxi Xi＇an 710002,China)

机构地区：[1]陕西省西安市第一医院干部病房科,陕西西安710002 [2]陕西省宝鸡市中心医院呼吸内科,陕西宝鸡721008

出　　处：《河北医学》2018年第9期1424-1429,共6页Hebei Medicine

基　　金：陕西省卫生厅科学研究基金项目;(编号:2018SF-218)

摘　　要：目的:探讨血清可溶性髓系细胞触发受体1(s TREM-1)联合免疫检测对老年重症肺炎糖皮质激素治疗后的短期转归预测价值。方法:纳入本院2014年2月至2017年6月收治的老年重症肺炎患者92例,均采用糖皮质激素治疗。在患者入院时采集血样检测血清s TREM-1以及免疫球蛋白A(lg A)、免疫球蛋白M(lg M)、免疫球蛋白G(lg G)水平。根据患者的治疗转归情况,将其分成转归良好组、转归不良组,比较两组临床特征,通过绘制受试者工作特征曲线(ROC)分析血清s TREM-1联合免疫检测对患者转归的预测价值。采用Logistic回归性分析明确患者短期预后不良的独立危险因素。结果:在92例患者中,转归良好占70.65%,转归不良占29.35%;转归良好组的血清sTREM-1水平低于转归不良组,血清lgA、lgM、lgG水平高于转归不良组,组间比较有统计学意义(P<0.05);血清sTREM-1血清lgA、血清lgM、血清lgG及四者联合预测患者短期预后不良的曲线下面积分别为0.812、0.793、0787、0.852、0.869。Logistic回归性分析提示血清sTREM-1>74.225pg/mL、血清lgA<0.674g/L、血清lgM<0.947g/L、血清lgG<5.755g/L为患者短期预后不良的危险因素(P<0.05)。结论:血清sTREM-1联合免疫检测预测老年重症肺炎短期转归的敏感度、特异度较高,临床可将其作为评估患者病情的重要指标。果:在92例患者中,转归良好占70.65%,转归不良占29.35%;转归良好组的血清sT REM-1水平低于转归不良组,血清lg A、lg M、lg G水平高于转归不良组,组间比较有统计学意义(P<0.05);血清sT REM-1、血清lg A、血清lg M、血清lg G及四者联合预测患者短期预后不良的曲线下面积分别为0.812、0.793、0.787、0.852、0.869。Logistic回归性分析提示血清sT REM-1>74.225pg/mL、血清lg A<0.674g/L、血清lg M<0.947g/L、血清lg G<5.755g/L为患者短期预后不良的危险因素(P<0.05)。结论:血清sT REM-1联合免疫检测预测老年重症肺炎短期转归Objective： To explore the predictive value of serum soluble myeloid cell trigger receptor 1（ s TREM-1） combined with immunoassay in the short-term prognosis of elderly patients with severe pneumonia after glucocorticoid treatment. Methods： 92 patients with severe pneumonia treated in our hospital from Feb. 2014 to Jun. 2017 were treated with glucocorticoid. The serum levels of s TREM-1,immunoglobulin A（ lg A）,immunoglobulin M（ lg M） and immunoglobulin G（ lg G） were collected at the time of admission to the hospital.According to the treatment outcome of patients,they were divided into good outcome group and poor outcome group. The clinical characteristics of the two groups were compared. The predictive value of serum s TREM-1 combined immunoassay for prognosis of the patients was analyzed by drawing ROC curve. Logistic regression analysis was used to identify the independent risk factors of poor short-term prognosis. Results： Among the 92 patients,70. 65% were well transferred and 29. 35% had poor prognosis. The serum s TREM-1 level in the good outcome group was lower than that in the adverse outcome group,and the levels of lg A,lg M and lg G in serum were higher than those in the adverse outcome group. There was a statistically significant difference between the two groups（ P〈0.05）. The area under the curve of serum strem-1,serum lg A,serum lg M,serum lg G and four combined to predict the short-term prognosis of patients was 0.812,0.793,0.787,0.852 and 0.869,respectively.Logistic regression analysis showed that serum s TREM-1 74.225 pg/m L,serum lg A0.674 g/L,serum lg M0.947 g/L and serum lg G 5.755 g/L were the risk factors of poor short-term prognosis（ P〈0.05）. Conclusion： Serum s TREM-1 combined with immunoassay has a high sensitivity and specificity in predicting the short-term prognosis of elderly patients with severe pneumonia. It can be used as an important index for evaluating the condition of patients.

关 键 词：重症肺炎 免疫检测 STREM-1 

分 类 号：R563.1[医药卫生—呼吸系统]