血清高密度脂蛋白联合可溶性髓系细胞触发受体-1评估肺部感染脓毒症患者预后的价值  

Value of Combined Detection of High-density Lipoprotein Cholesterol and Soluble Triggering Receptor Expressed on Myelocytes-1 in Assessment of the Prognosis of Patients with Sepsis of Pneumonia

作　　者：沈丽娟[1] SHEN Li-juan(Intensive Care Unit,Wuxi Hospital Affiliated to Nanjing University of Chinese Medicine,Wuxi 214071,Jiangsu,China)

机构地区：[1]南京中医药大学无锡附属医院重症医学科,江苏无锡214071

出　　处：《医学信息》2021年第22期31-33,共3页Journal of Medical Information

基　　金：无锡市卫健委中青年医疗卫生拔尖人才资助计划(编号:BJ2020067)。

摘　　要：目的探讨血清高密度脂蛋白胆固醇(HDL-C)联合可溶性髓系细胞触发受体-1(sTREM-1)在评估肺部感染脓毒症患者预后中的应用价值。方法选取2014年1月-2019年12月我院重症医学科收治的49例肺部感染导致的脓毒症患者,记录患者入院时一般资料、入院24 h内急性生理学与慢性健康状况评分(APACHEⅡ)和序贯器官衰竭评分(SOFA);检测入院时白细胞总数、C反应蛋白、血清HDL-C和sTREM-1水平。随访患者预后情况,根据存活情况将脓毒症患者分为存活组和死亡组,比较两组患者白细胞总数、C反应蛋白、HDL-C、sTREM-1水平以及APACHEⅡ和SOFA评分;分析死亡组患者HDL-C和sTREM-1水平与APACHEⅡ的相关性;采用受试者工作特征(ROC)曲线分析HDL-C和sTREM-1水平对患者死亡的预测价值。结果49例患者中34例存活,15例死亡;死亡组HDL-C水平低于存活组,差异有统计学意义(P<0.05);死亡组sTREM-1水平、APACHEⅡ和SOFA评分高于存活组,差异有统计学意义(P<0.05);死亡组HDL-C与APACHEⅡ呈负相关(r=-0.520,P<0.05),sTREM-1水平与APACHEⅡ呈正相关(r=0.623,P<0.05);ROC曲线显示,HDL-C和sTREM-1联合检测的曲线下面积为0.88,高于HDL-C(0.81)和sTREM-1(0.85)单独检测。结论血清HDL-C、sTREM-1水平与肺部感染脓毒症患者病情的严重程度和预后有关,可作为肺部感染脓毒症患者预后评价的有效指标。Objective To investigate the value of combined detection of high-density lipoprotein cholesterol(HDL-C)and soluble triggering receptor expressed on myelocytes-1(sTREM-1)in assessment of the severity and prognosis of patients with sepsis of pneumonia.Methods From January 2014 December to June 2019,49 patients with sepsis of pneumonia in Wuxi Hospital Affiliated to Nanjing University of Chinese Medicine were selected,and the basic data,acute physiology and chronic health evaluation(APACHEⅡ)score and sequential organ failure assessment(SOFA)score were recorded.Serum levels of WBC,CRP,HDL-C and sTREM-1 were detected at admission.The patients were followed up for survival and were divided into survival group and death group,WBC,CRP,HDL-C,sTREM-1 levels,APACHEⅡand SOFA scores were compared between the two groups.The correlation between the levels of HDL-C and sTREM-1 in the death group and APACHE II was analyzed.The predictive value of HDL-C and sTREM-1 levels for death was analyzed by receiver operating characteristic(ROC)curve.Results Of the 49 patients,34 survived and 15 died;HDL-C level in the death group was lower than that in the survival group,and the difference was statistically significant(P<0.05).The sTREM-1 level,APACHEⅡand SOFA scores in the death group were higher than those in the survival group,and the difference was statistically significant(P<0.05).HDL-C in the death group was negatively correlated with APACHEⅡscore(r=-0.520,P<0.05),and sTREM-1 level was positively correlated with APACHEⅡscore(r=0.623,P<0.05).ROC curve showed that the area under the curve for the combined detection of HDL-C and sTREM-1 was 0.88,which was higher than that for the separate detection of HDL-C(0.81)and sTREM-1(0.85).Conclusion The serum levels of HDL-C and sTREM-1 are related to the severity and prognosis of patients with sepsis of pneumonia,and could be used as effective index to predict the prognosisof patients with sepsis of pneumonia.

关 键 词：高密度脂蛋白胆固醇 可溶性髓系细胞触发受体-1 脓毒症 肺部感染 

分 类 号：R459.7[医药卫生—急诊医学]