可溶性髓系细胞表达触发受体-1评估重症肺炎病情的价值  

Value of soluble myeloid cells triggering receptor-1 expression in the assessment of severe pneumonia

作　　者：杨志明[1] 陈鸣娣 刘晓月 邹天士[1] 林颖[1] YANG Zhiming;CHEN Mingdi;LIU Xiaoyue;ZOU Tianshi;LIN Ying(Department of Respiratory Medicine,the First People's Hospital of Zhaoqing City in Guangdong Province,Zhaoqing 526000,China;Intensive Care Unit,the Second Affiliated Hospital of Guangdong Medical University,Zhanjiang 524003,China;Science Education Museum(Guangdi Geological Sanatorium),Guangdong Provincial Geological Bureau,Zhaoqing526000,China)

机构地区：[1]广东省肇庆市第一人民医院呼吸内科,广东肇庆526000 [2]广东医科大学附属第二医院重症监护室,广东湛江524003 [3]广东省地质局科普教育馆(广地地质疗养院),广东肇庆526000

出　　处：《中国现代医生》2020年第5期34-37,共4页China Modern Doctor

基　　金：广东省肇庆市科技创新指导类项目(201804030711)。

摘　　要：目的分析重症肺炎患者血浆可溶性髓系细胞表达触发受体-1(sTREM-1)水平变化及临床意义。方法选取2018年6月~2019年3月在广东医科大学附属第二医院重症监护室治疗的重症肺炎24例(设为重症肺炎组),其中有15例病情好转(好转组),选取健康体检者19例作为对照组,采用ELISA方法检测重症肺炎组入住ICU第1天、好转组病情稳定转至普通病房当天及对照组体检当天的sTREM-1水平,并记录重症肺炎患者入住ICU第1天及其转出病房当天的急性生理学与慢性健康状况(APACHEⅡ)评分。比较各组sTREM-1水平差异,统计分析sTREM-1与APACHEⅡ评分的相关性。结果血浆sSTREM-1水平在重症肺炎组、好转组和对照组比较,差异无统计学意义(P>0.05)。重症肺炎组APACHEⅡ评分较好转组明显升高,差异有统计学意义(P<0.05)。重症肺炎患者第1天血浆sTREM-1水平与APACHⅡ评分无明显相关性(r=-2.53,P=0.223)。结论sTREM-1用于重症肺炎的病情评估、预后判断尚需持谨慎态度。Objective To analyze the changes of plasma soluble myeloid cells triggering receptor-1(sTREM-1)levels and their clinical significance in patients with severe pneumonia.Methods 24 patients with severe pneumonia from June 2018 to March 2019 in the ICU of the Second Affiliated Hospital of Guangdong Medical University were selected and set as severe pneumonia group,of whom 15 cases were improved(improved group).19 healthy physical examination cases were selected as the control group.STREM-1 levels of the severe pneumonia on the first day of ICU,on the day of stable transfer to the general ward of the improved group and on the day of the physical examination of the control group were detected by ELISA method.The acute physiology and chronic health status(APACHEⅡ)scores of patients with severe pneumonia on the first day of admission to the ICU and the day they were transferred out of the ward were recorded.The differences of sTREM-1 level in each group were compared,and the correlation between sTREM-1 and APACHEⅡscore was statistically analyzed.Results There was no statistically significant difference of plasma sTREM-1 level among the severe pneumonia group,the improved group and the control group(P>0.05).The APACHEⅡscore in the severe pneumonia group was obviously higher than that in the improved group,with statistically significant difference(P<0.05).There was no significant correlation between plasma sTREM-1 level and APACHⅡscore on the first day in patients with severe pneumonia(r=-2.53,P=0.223).Conclusion sTREM-1 should be used with caution in assessing the condition and prognosis of severe pneumonia.

关 键 词：可溶性髓系细胞表达触发受体-1 重症肺炎 APACHEⅡ评分 

分 类 号：R563.1[医药卫生—呼吸系统]