重症肺炎患者血清Fn,Copeptin及sTREM-1水平变化及临床意义  

Changes and Clinical Significance of Serum Levels of Fn,Copeptin and sTREM-1 in Patients with Severe Pneumonia

作　　者：符征高 陈钰 梁勇 许俊旭 吴挺实 郝金香 FU Zheng-gao;CHEN Yu;LIANG Yong;XU Jun-xu;WU Ting-shi;YU Jin-xiang(the Third People’s Hospital of Haikou City,Haikou 571100,China)

机构地区：[1]海口市第三人民医院,海口571100

出　　处：《现代检验医学杂志》2021年第4期111-115,共5页Journal of Modern Laboratory Medicine

基　　金：海南省自然科学基金(818QN318)。

摘　　要：目的观察重症肺炎患者血清纤维结合蛋白(Fn)、和肽素(Copeptin)、可溶性髓样细胞触发受体1(sTREM-1)水平变化,分析其与病情严重程度以及预后的关系。方法选择122例社区获得性重症肺炎患者(肺炎组),根据APACHEⅡ将患者分为低危组(<10分,45例),中危组(10~20分,43例)和高危组(>20分,34例),根据28天内生存情况分为死亡组(31例)和存活组(91例),另选择92例健康志愿者为对照组。检测血清Fn,Copeptin和sTREM-1水平,分析其与重症肺炎患者病情和预后的关系。结果肺炎组血清Fn水平为177.26±31.94mg/L,低于对照组231.26±21.54mg/L(t=8.751,P<0.001),血清Copeptin和sTREM-1水平分别为70.45±0.47pmol/L,169.26±31.94pg/ml,高于对照组的55.45±7.06pmol/L和34.18±9.54pg/ml(t=12.637,39.235,P<0.001)。血清Copeptin和sTREM-1水平在低危组、中危组、高危组依次升高,Fn水平依次降低,各组间差异均有统计学意义(均P<0.05)。治疗后肺炎患者血清Fn水平升高(t=8.977,P<0.05),Copeptin和sTREM-1水平降低(t=20.941,31.982,均P<0.05)。死亡组血清Fn和sTREM-1水平低于存活组(t=6.377,8.285,均P<0.001),血清Copeptin水平高于存活组(t=7.845,P<0.001)。血清Fn水平与CPIS评分,APACHEⅡ评分呈负相关(rs=-0.569,-0.632,均P<0.001),与OI指数呈正相关(r=0.496,P<0.01)。血清Copeptin,sTREM-1水平与CPIS评分,APACHEⅡ评分呈正相关(rs=0.573,0.603,0.517和0.529,均P<0.001),与OI指数呈负相关(r=-0.437,-0.506,均P<0.01)。低水平Fn(OR=0.768,95%CI:0.617~0.806),高水平Copeptin(OR=1.650,95%CI:1.523~1.769),高水平sTREM-1(OR=1.602,95%CI:1.543~1.732)是重症肺炎患者死亡的危险因素(P<0.01)。结论重症肺炎患者血清Fn水平降低,Copeptin,sTREM-1水平升高,低水平Fn,高水平Copeptin和sTREM-1与患者病情加重和不良预后有关。Objective:To analyze the relationship between serum levels of Fibronectin(Fn),Copeptin and soluble myeloid cell triggered receptor 1(sTREM-1)in patients with severe pneumonia and their severity and prognosis.Methods 122 cases of community acquired with severe pneumonia group(pneumonia),according to the APACHEⅡthe patients were divided into low-risk groups(<10 points,45 cases),moderate group(10 to 20 points,43 cases),and high risk group(>20 points,34 cases),according to the survival conditions within 28 d were divided into death group(31 cases)and survival group(91 cases),and another 92 healthy volunteers were selected as the control group.Serum levels of Fn,Copeptin and sTREM-1 were detected to analyze their relationship with the condition and prognosis of patients with severe pneumonia.Results The serum Fn level of pneumonia group was 177.26±31.94 mg/L,which were lower than that of control group 231.26±21.54 mg/L(t=8.751,P<0.001),and the serum Copeptin and sTREM-1 levels were 70.45±0.47pmol/L,169.26±31.94pg/ml,respectively,which were higher than that of control group 55.45±7.06 pmol/L and 34.18±9.54 pg/ml(t=12.637,39.235,P<0.001).Serum Copeptin and sTREM-1 levels were increased successively in the low-risk group,medium-risk group and high-risk group,while FN level was decreased successively,with statistical significance among all groups(all P<0.05).After treatment,the serum FN level of patients with pneumonia was increased(t=8.977,P<0.05),while the levels of Copeptin and sTREM-1 were decreased(t=20.941,31.982,all P<0.05).Serum Fn and sTREM-1 levels in the death group were lower than those in the survival group(t=6.377,8.285,all P<0.001),and Copeptin levels were higher than those in the survival group(t=7.845,P<0.001).Serum Fn level were negatively correlated with CPIS score,APACHEⅡscore negatively correlated(rs=-0.569,-0.632,P<0.001),and were positively correlated with OI index(r=0.496,P<0.01).Serum copeptin and sTREM-1 levels were positively correlated with CPIs score and ApacheⅡscore(rs=0.573,0.603

关 键 词：重症肺炎 纤维结合蛋白 和肽素 可溶性髓样细胞触发受体1 

分 类 号：R563.1[医药卫生—呼吸系统] R392.11[医药卫生—内科学]