sTREM-1及CD64与PCT对烧伤后并发脓毒症的诊断价值  

Value of soluble myeloid cell trigger receptor-1, CD64 and procalcitonin in diagnosis of burn patients complicated with sepsis

作　　者：周敏[1] 王信春[1] 郭丽 陈洪[1] 黄代萍 王良君 ZHOU Min;WANG Xin-chun;GUO Li;CHEN Hong;HUANG Dai-ping;WANG Liang-jun(Neijiang First People′s Hospital,Neijiang,Sichuan 641000,China)

机构地区：[1]内江市第一人民医院烧伤整形科,四川内江641000

出　　处：《中华医院感染学杂志》2020年第2期216-219,共4页Chinese Journal of Nosocomiology

基　　金：四川省科技支撑计划基金资助项目(2016S38102)。

摘　　要：目的探讨烧伤并发脓毒症患者外周血可溶性髓系细胞触发受体-1(Soluble myeloid cell trigger receptor-1,sTREM-1)、CD64及血清降钙素原(Procalcitonin,PCT)的水平变化及其诊断价值。方法选取2015年3月-2018年3月内江市第一人民医院收治的108例烧伤患者作为研究对象,根据是否并发感染分为非感染组40例、局部感染组50例、脓毒症组18例,检测三组患者的sTREM-1、CD64及PCT水平,并绘制受试者工作曲线(ROC)分析三项指标单独及联合应用诊断脓毒症的价值。结果脓毒症组患者烧伤面积(49.0±4.7)%、Ⅲ°烧伤面积(17.3±3.5)%均大于局部感染组和非感染组,差异具有统计学意义(P<0.05);脓毒症组患者sTREM-1、CD64和PCT水平高于局部感染组和非感染组,局部感染组高于非感染组,比较差异均具有统计学意义(P<0.05);sTREM-1、CD64及PCT指标联合应用诊断烧伤后脓毒症的ROC曲线下面积(AUC)为0.947、诊断灵敏度为97.36%、特异度为90.77%。结论烧伤后脓毒症组患者sTREM-1、CD64及PCT水平升高显著,指标联合检测对临床诊断烧伤患者并发脓毒症感染具有一定的价值。OBJECTIVE To explore the changes of levels of peripheral blood soluble myeloid cell trigger receptor-1(sTREM-1), CD64 and serum procalcitonin(PCT) in the burn patients complicated with sepsis and analyze their diagnostic values. METHODS A total of 108 burn patients who were treated in Neijiang First People′s Hospital from Mar 2015 to Mar 2018 were recruited as the study objects and divided into the non-infection group with 40 cases, the local infection group with 50 cases and the sepsis group with 18 cases according to the status of complication with infection.The levels of sTREM-1, CD64 and PCT of the three groups of patients were detected, and the values of the single and joint detection of the three indexes in diagnosis of sepsis were analyzed by means of receiver-operating-characteristic(ROC) curve. RESULTS The burn area and the third degree burn area of the sepsis group were respectively(49.0±4.7)% and(17.3±3.5)%, significantly larger than those of the local infection group and the non-infection group(P<0.05).The levels of sTREM-1, CD64 and PCT of the sepsis group were significantly higher than those of the local infection group and the non-infection group, and the levels of the above indexes of the local infection group were significantly higher than those of the non-infection group(P<0.05).The area under ROC curve(AUC) of the joint detection of sTREM-1, CD64 and PCT was 0.947 in diagnosis of the burn patients with sepsis, the sensitivity was 97.36%, the specificity was 90.77%. CONCLUSION The levels of sTREM-1, CD64 and PCT of the burn patients with sepsis are remarkably elevated, and the joint detection of the indexes has certain value in clinical diagnosis of the burn patients complicated with sepsis.

关 键 词：可溶性髓系细胞触发受体-1 CD64 降钙素原 脓毒症 

分 类 号：R631.1[医药卫生—外科学]