VAP血清PCT、IL-6、sTREM-1水平与CPIS评分的相关性研究  

Correlation between levels of serum PCT, IL-6 and sTREM-1 and CPIS score in VAP cases

作　　者：田洪梅 张川[1] 乐涛[1] 程金川[1] 李晓玉[1] 任韩雯婧 杨文霞 Tian Hongmei;Zhang Chuan;Yue Tao;Cheng Jinchuan;Li Xiaoyu;Ren Hanwenjing;Yang Wenxia(Department of Critical Care Medicine,Chengdu Third People's Hospital,Chengdu,Sichuan,610000,China)

机构地区：[1]成都市第三人民医院重症医学科,成都610000

出　　处：《西南国防医药》2020年第8期712-715,共4页Medical Journal of National Defending Forces in Southwest China

基　　金：四川省医学会(宜昌人福)专项课题(2016ZZ002)。

摘　　要：目的探讨呼吸机相关性肺炎(VAP)血清降钙素原(PCT)、白介素-6 (IL-6)、可溶性髓细胞表达触发受体-1(sTREM-1)水平与临床肺部感染(CPIS)评分的相关性。方法选择医院行机械通气治疗且出现VAP的93例患者作为VAP组,另选择同期行机械通气治疗但未出现VAP的41例患者作为常规组,根据VAP组患者CPIS评分将其分为CPIS评分>6分组(n=25)和CPIS评分≤6分组(n=68),比较VAP组和常规组、不同CPIS评分VAP患者血清PCT、IL-6、sTREM-1及CPIS评分水平,分析PCT、IL-6、sTREM-1水平与CPIS评分的相关性以及联合检测对VAP的诊断价值。结果 VAP组患者血清PCT、IL-6、sTREM-1水平及CPIS评分明显高于常规组(P <0.05);CPIS评分>6分组患者血清PCT、IL-6、sTREM-1水平明显高于CPIS评分≤6分组(P <0.05);Pearson相关性分析显示,血清PCT、IL-6、sTREM-1与CPIS评分均呈明显正相关(r=0.513,0.650,0.597,P <0.05);PCT、IL-6、sTREM-1及CPIS联合诊断VAP的AUC为0.864(95%CI 0.792~0.935),灵敏度为86.00%,优于各指标单一检测。结论血清PCT、IL-6、sTREM-1水平与VAP患者CPIS评分密切相关,上述指标有望成为诊断VAP的生物标志物。Objective To explore the correlation between the levels of serum procalcitonin(PCT), interleukin-6(IL-6) and soluble triggering receptor expressed on myeloid cell-1(sTREM-1) and clinical pulmonary infection score(CPIS) in ventilatorassociated pneumonia(VAP) cases. Methods A total of 93 patients who were treated with mechanical ventilation and developed VAP in our hospital were included in the VAP group and 41 patients who were treated with mechanical ventilation in our hospital in the same period but did not develop VAP were included in the control group. According to the CPIS score, the patients in the VAP group were divided into a subgroup with CPIS score > 6 points(n=25) and a subgroup with CPIS score ≤ 6 points(n=68). The levels of serum PCT, IL-6 and sTREM-1 and CPIS score were compared between the VAP group and the control group and among VAP patients with different CPIS scores. The correlation between levels of PCT, IL-6 and sTREM-1 and CPIS score, and the value of the combination for diagnosis of VAP was analyzed. Results The levels of serum PCT, IL-6 and sTREM-1 and CPIS score in the VAP group were significantly higher than those in the control group(P < 0.05). The levels of serum PCT, IL-6 and sTREM-1 among patients with CPIS score > 6 points were significantly higher than those among patients with CPIS score ≤ 6 points(P < 0.05).Pearson correlation analysis showed that all serum PCT, IL-6 and sTREM-1 were significantly positively correlated with CPIS score(r=0.513, 0.650, 0.597, P < 0.05). The AUC and sensitivity of combination of PCT, IL-6, sTREM-1 and CPIS in diagnosing VAP were0.864(95% CI 0.792-0.935) and 83.87%, which were better than those of any indicator alone. Conclusion The levels of serum PCT,IL-6 and sTREM-1 are closely related to the CPIS score in patients with VAP, and the above indicators are expected to be the biomarkers for diagnosis of VAP.

关 键 词：呼吸机相关性肺炎 降钙素原 白介素-6 可溶性髓细胞表达触发受体-1 临床肺部感染评分 

分 类 号：R563.1[医药卫生—呼吸系统]