血清sTREM-1、AGEs水平与连续肾脏替代疗法治疗脓毒症患者预后的相关性  

Correlation between serum sTREM-1 and AGEs levels and prognosis of patients with sepsis treated with continuous renal replacement therapy

作　　者：符超 王日兴[1] 吕有凯 FU Chao;WANG Rixing;LYU Youkai(Emergency Department,Second Affiliated Hospital of Hainan Medical University,Haikou,Hainan 570311,China)

机构地区：[1]海南医学院第二附属医院急诊科,海南海口570311

出　　处：《国际检验医学杂志》2021年第17期2099-2104,共6页International Journal of Laboratory Medicine

基　　金：海南省卫生计生行业科研项目(20A200014)。

摘　　要：目的分析血清可溶性髓系细胞触发因子-1(sTREM-1)、晚期糖基化终末产物(AGEs)水平与脓毒症患者经连续肾脏替代疗法(CRRT)治疗后预后不佳的关系。方法选取2018年1月至2020年1月该院重症监护室(ICU)接受CRRT治疗的69例脓毒症患者,全部患者均接受CRRT治疗,均于治疗28 d后记录患者病死情况,患者病死视为预后不良,并以此将患者分为预后不良组和预后良好组。调查患者一般资料、检测实验室指标并比较,重点分析CRRT治疗前血清sTREM-1、AGEs与患者预后不良的关系。结果全部69例脓毒症患者,经CRRT治疗28 d后病死23例,病死率为33.33%;预后不良组血清TLR9、基质金属蛋白酶-9(MMP-9)、sTREM-1、AGEs水平均高于预后良好组(P<0.05),组间其他资料比较差异无统计学意义(P>0.05);Logistic回归分析结果显示,治疗前血清TLR9、MMP-9、sTREM-1、AGEs与经CRRT治疗的脓毒症患者预后有关,各指标水平过高可能是经CRRT治疗的脓毒症患者预后不良的风险因子(OR>1,P<0.05);绘制受试者工作特征(ROC)曲线,结果显示,治疗前血清TLR9、MMP-9、sTREM-1、AGEs分别预测脓毒症患者经CRRT治疗后预后不良风险的曲线下面积(AUC)均>0.80,且以治疗前血清TLR9、MMP-9、sTREM-1、AGEs的cut-off值分别为17.262 ng/mL、31.030μg/L、383.292 pg/mL、11.872μg/L时,预测价值最佳;相关性分析结果显示,脓毒症患者治疗前血清sTREM-1水平与AGEs水平之间呈正相关(r=0.340,P=0.004)。结论血清sTREM-1、AGEs水平与脓毒症患者经CRRT治疗后预后不良有关,可能是患者预后不良的风险因子,对预测患者经CRRT治疗后预后风险有一定价值。Objective To analyze the relationship between serum soluble triggering factor-1(sTREM-1),advanced glycation end products(AGEs)and poor prognosis of patients with sepsis after continuous renal replacement therapy(CRRT).Methods A total of 69 patients with sepsis who received CRRT treatment in ICU from January 2018 to January 2020 were prospectively enrolled in the study,all patients received CRRT,the mortality was recorded 28 d after treatment,patients who died were considered to have poor prognosis,and the patients were divided into poor prognosis group and good prognosis group.The general data of the patients were investigated and compared,the relationship between serum sTREM-1,AGEs and poor prognosis before CRRT treatment was analyzed.Results Among 69 patients with sepsis,23 patients died after 28 days of CRRT treatment,the mortality rate was 33.33%;the levels of TLR9,MMP-9,sTREM-1 and AGEs in the poor prognosis group were higher than the good prognosis group(P<0.05),compared other data between the two groups,the difference was not statistically significant(P>0.05);the results of Logistic regression analysis showed that serum TLR9,MMP-9,sTREM-1 and AGEs were related to the prognosis of patients with sepsis after CRRT treatment,overexpression of each indicator may be a risk factor for poor prognosis of patients with sepsis after CRRT treatment(OR>1,P<0.05);ROC curve was drawn,and the results showed that the AUCs of TLR9,MMP-9,sTREM-1 and AGEs respectively predicted the risk of adverse prognosis in patients with sepsis after CRRT treatment were all>0.80,and when the cut-off value of TLR9,MMP-9,sTREM-1 and AGEs before treatment were 17.262 ng/mL,31.030μg/L,383.292 pg/mL and 11.872μg/L,respectively,the predictive value was the best;the results of correlation analysis showed that there was a positive correlation between serum sTREM-1 level and AGEs level in patients with sepsis before treatment(r=0.340,P=0.004).Conclusion Serum levels of sTREM-1 and AGEs are associated with poor prognosis in patients with sepsis af

关 键 词：脓毒症 连续肾脏替代疗法 预后 可溶性髓系细胞触发因子-1 晚期糖基化终末产物 相关性 

分 类 号：R446.11[医药卫生—诊断学]