血清sTREM-1、CD40L水平在老年多重耐药菌血流感染早期诊断中的应用价值  

The application value of serum sTREM-1 and CD40L levels in the early diagnosis of multidrug-resistant organism bloodstream infections in the elderly

作　　者：胡慧琴 卢铨广 HU Huiqin;LU Quanguang(Department of Pharmacy,Zhongshan Xiaolan People's Hospital,Zhongshan 528415,Guangdong,China)

机构地区：[1]广东省中山小榄人民医院药学部,广东中山528415

出　　处：《中国病原生物学杂志》2023年第9期1070-1073,1078,共5页Journal of Pathogen Biology

摘　　要：目的 探究血清可溶性髓系细胞触发受体-1(sTREM-1)、CD40配体(CD40L)水平在老年多重耐药菌(MDRO)血流感染早期诊断中的应用价值。方法 选取本院自2019年3月至2022年10月收诊的163例老年MDRO血流感染患者为研究组,另选取168例非MDRO血流感染老年患者为对照组。酶联免疫吸附试验(ELISA)检测血清sTREM-1和CD40L水平;收集患者临床资料并采用Logistic多因素回归分析法分析老年MDRO血流感染的影响因素;采用受试者工作特征(ROC)曲线预测血清sTREM-1和CD40L水平对老年MDRO血流感染的诊断价值。结果 与对照组比较,研究组血清sTREM-1和CD40L水平均明显较高(P<0.05);单因素分析结果表明,机械通气、APACHE II评分、抗菌药物使用≥3种、入住ICU是老年MDRO血流感染的影响因素(P<0.05);多因素分析结果显示,血清sTREM-1、CD40L、机械通气、APACHE II评分是老年MDRO血流感染的影响因素(P<0.05)。ROC结果显示,血清sTREM-1水平单独预测老年MDRO血流感染的AUC为0.849,最佳截断值为55.82 pg/mL,灵敏度、特异性分别为71.78%、85.12%;血清CD40L水平单独预测老年MDRO血流感染的AUC为0.829,其灵敏度、特异性分别为69.33%、86.31%,最佳截断值为3.62 ng/mL;两者联合预测老年MDRO血流感染的AUC(0.902)显著大于血清sTREM-1水平单独预测的AUC(Z=3.308,P=0.000)和CD40L水平单独预测的AUC(Z=3.867,P=0.000)。结论 老年MDRO血流感染患者血清sTREM-1和CD40L水平升高,二者对老年MDRO血流感染的早期诊断具有重要意义。Objective To explore the application value of serum soluble triggering receptor expressed on myeloid cells-1(sTREM-1)and CD40 ligand(CD40L)levels in the early diagnosis of elderly multidrug-resistant organism(MDRO)bloodstream infection.Methods A total of 163 elderly patients with MDRO bloodstream infection admitted to our hospital from March 2019 to October 2022 were collected as the study group,another 168 elderly patients with non MDRO bloodstream infection were collected as the control group.Enzyme linked immunosorbent assay(ELISA)was applied to detect serum levels of sTREM-1 and CD4OL;clinical data were collected from patients and Logistic multiple factor regression analysis method was applied to analyze the influencing factors of blood flow infection in elderly MDRO patients;receiver operating characteristic(ROC)curve was applied to predict the diagnostic value of serum sTREM-1 and CD40L levels in elderly MDRO bloodstream infectionsR.esults Compared with the control group,the serum levels of sTREM-1 and CD40L in the study group were obviously higher(P<0.05);the results of univariate analysis showed that mechanical ventilation,APACHE II score,use of antibiotics≥3 types,and admission to the ICU were the influencing factors for elderly MDRO blood flow infection(P<0.05);the results of multivariate analysis showed that serum sTREM-1,CD40L,mechanical ventilation,and APACHE II score were the influencing factors of elderly MDRO bloodstream infection(P<0.05).ROC results showed that the AUC of serum sTREM-1 alone in predicting elderly MDRO bloodstream infection was 0.849,with an optimal cutoff value of 55.82 pg/mL,sensitivity and specificity of 71.78%and 85.12%,respectively;the AUC of serum CD40L level alone in predicting elderly MDRO bloodstream infection was 0.829,with sensitivity and specificity of 69.33%and 86.31%,respectively,the optimal cutoff value was 3.62 ng/mL;the AUC of combined prediction for elderly MDRO bloodstream infection(0.902)was obviously higher than that predicted by serum sTREM-1 levels alone(Z

关 键 词：可溶性髓系细胞触发受体-1 CD40配体 多重耐药菌 血流感染 诊断价值 

分 类 号：R378[医药卫生—病原生物学]