重症肺炎患者血清sTREM-1、TIMP-1、NT-proBNP表达及与其病情、预后的关联性  

Expression of serum sTREM-1, TIMP-1 and NT-proBNP in patients with severe pneumonia and its correlation with their disease conditions and prognoses

作　　者：白碧慧 陈余思[1] 宋本艳 张榆铃 BAI Bi-hui;CHEN Yu-si;SONG Ben-yan;ZHANG Yu-ling(Department of Respiratory and Critical Care Medicine,Panzhihua Hospital of Integrated Traditional Chinese and Western Medicine,Panzhihua,Sichuan 617000,China)

机构地区：[1]攀枝花市中西医结合医院呼吸与危重医学科,四川攀枝花617000

出　　处：《实用预防医学》2021年第8期956-960,共5页Practical Preventive Medicine

摘　　要：目的探究重症肺炎患者血清可溶性髓系细胞表达的触发受体-1(soluble triggering receptor expressed on myeloid cells-1,sTREM-1)、基质金属蛋白酶抑制剂-1(tissue inhibitor of metalloproteinase-1,TIMP-1)、N末端脑钠肽前体(N-terminal pro-brain natriuretic peptide, NT-proBNP)表达及与其病情、预后的关联性。方法选取2018年6月-2020年2月攀枝花市中西医结合医院84例重症肺炎患者为重症组,同期84例普通肺炎患者为普通组,另随机选取84例健康体检者为对照组。检测比较重症组和普通组入院当天以及对照组体检当天、重症组入院第3 d、第5 d血清sTREM-1、TIMP-1、NT-proBNP水平,探究血清sTREM-1、TIMP-1、NT-proBNP与重症肺炎患者临床肺部感染评分(clinical pulmonary infection score, CPIS)、肺炎严重指数(pneumonia severity index, PSI)评分的关联性,并对比重症组不同预后(生存、死亡)患者一般资料与入院当天、入院第3 d、第5 d血清sTREM-1、TIMP-1、NT-proBNP水平,探讨各时间点血清指标表达与重症肺炎患者预后死亡的关系,血清指标对重症肺炎患者预后死亡的预测价值。结果重症组入院当天血清sTREM-1、TIMP-1、NT-proBNP水平>普通组>对照组(P<0.05);重症肺炎患者CPIS评分、PSI评分与入院当天血清sTREM-1、TIMP-1、NT-proBNP呈正相关(P<0.05);重症组死亡患者CPIS评分、PSI评分高于生存患者,死亡患者入院当天、入院第3 d、第5 d血清sTREM-1、TIMP-1、NT-proBNP表达高于生存患者(P<0.05);入院第5 d血清sTREM-1、TIMP-1、NT-proBNP水平预测重症肺炎患者预后死亡的曲线下面积(AUC)均在0.7以上,预测效果良好,尤其是各指标联合预测AUC高达0.916,最佳预测敏感度、特异度分别为80.00%、91.53%。结论重症肺炎患者血清sTREM-1、TIMP-1、NT-proBNP水平明显升高,与患者病情程度间存在密切相关性,检测重症肺炎患者入院时上述血清指标,有助于医生评估患者死亡风险。Objective To explore the expression of serum soluble triggering receptor expressed on myeloid cells-1(sTREM-1), tissue inhibitor of metalloproteinase-1(TIMP-1) and N-terminal pro-brain natriuretic peptide(NT-proBNP) in patients with severe pneumonia and its correlation with the patients’ disease condition and prognoses. Methods From June 2018 to February 2020, 84 patients with severe pneumonia from Panzhihua Hospital of Integrated Traditional Chinese and Western Medicine were selected as the severe group. During the same period, 84 patients with common pneumonia served as the ordinary group, and 84 healthy subjects were randomly selected as the control group. Serum levels of sTREM-1, TIMP-1 and NT-proBNP in the severe group and the ordinary group on the day of admission, the control group on the day of physical examination, and the severe group on the 3 rd and 5 th days of admission were detected and compared. The relationships of serum sTREM-1, TIMP-1 and NT-proBNP with the clinical pulmonary infection score(CPIS) and pneumonia severity index(PSI) score in the patients with severe pneumonia were explored. The general information of patients with different prognoses(survival or death) in the severe group and serum sTREM-1, TIMP-1 and NT-proBNP levels on the day of admission and the 3 rd and 5 th days of admission were compared. And the relationships among the expression of the serum indicators at each time point and prognoses and death of the patients with severe pneumonia, and the predictive values of the serum indicators for prognoses and death of the patients with severe pneumonia were explored. Results Serum sTREM-1, TIMP-1 and NT-proBNP levels on the day of admission were higher in the severe group than in the ordinary group(P<0.05) as well as higher in the ordinary group than in the control group (P<0.05). CPIS score and PSI score of the patients with severe pneumonia were positively correlated with serum sTREM-1, TIMP-1 and NT-proBNP on the day of admission(P<0.05). The CPIS score and PSI score of death

关 键 词：重症肺炎 可溶性髓系细胞表达的触发受体-1 基质金属蛋白酶抑制剂-1 N末端脑钠肽前体 预后 

分 类 号：R563.1[医药卫生—呼吸系统]