脑外伤术后机械通气患者血清sTREM⁃1、脂联素、PLR对VAP的预测价值  

Predictive value of serum sTREM⁃1,adiponectin and PLR for VAP in patients undergoing mechanical ventilation after traumatic brain injury surgery

作　　者：刘莹[1] 肖莹[1] 王晓庆[2] 张羽[1] LIU Ying;XIAO Ying;WANG Xiaoqing;ZHANG Yu(Operating Room,Lequn Hospital,The First Hospital of Jilin University,Changchun,Jilin,China,130000;Lequn Hospital,The First Hospital of Jilin University,Changchun,Jilin,China,130000)

机构地区：[1]吉林大学第一医院乐群院区手术室,吉林长春130000 [2]吉林大学第一医院乐群院区,吉林长春130000

出　　处：《分子诊断与治疗杂志》2024年第12期2299-2302,共4页Journal of Molecular Diagnostics and Therapy

基　　金：吉林省科技发展计划项目任务书(20180101200JC)。

摘　　要：目的分析脑外伤术后机械通气患者血清可溶性髓样细胞触发受体⁃1(sTREM⁃1)、脂联素、血小板/淋巴细胞比值(PLR)对呼吸机相关性肺炎(VAP)的预测价值。方法选取2022年4月至2023年12月吉林大学第一医院收取的96例脑外伤术后行机械通气患者,检测所有受试对象入院血清sTREM⁃1、ADPN及PLR水平;依据患者是否发生VAP将其分为VAP组(n=33)及非VAP组(n=63),分析脑外伤术后机械通气患者发生VAP的危险因素,采用受试者工作特征(ROC)曲线分析血清sTREM⁃1、脂联素、PLR对VAP发生的预测价值。结果VAP组血清sTREM⁃1、PLR水平高于非VAP组,脂联素水平低于非VAP组,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,血清sTREM⁃1、PLR水平升高为脑外伤术后机械通气患者发生VAP的危险因素,脂联素水平升高为脑外伤术后机械通气患者发生VAP的保护因素(P<0.05)。ROC曲线分析结果显示,sTREM⁃1、脂联素、PLR联合检测诊断VAP发生的AUC、敏感度及特异度分别为0.921、0.903、0.938,均高于单一指标检测(P<0.05)。结论血清sTREM⁃1、脂联素、PLR异常表达是脑外伤术后机械通气患者发生VAP的影响因素,可用于辅助诊断脑外伤术后机械通气患者并发VAP。Objective To analyze the predictive value of serum soluble triggering receptor ex⁃pressed on myeloid cells⁃1(sTREM⁃1),adiponectin(ADPN)and platelet to lymphocyte ratio(PLR)for ven⁃tilator⁃associated pneumonia(VAP)in patients undergoing mechanical ventilation after surgery for traumatic brain injury.Methods A total of 96 patients who underwent surgery for traumatic brain injury at the First Hospital of Jilin University from April 2022 to December 2023 and received mechanical ventilation were se⁃lected.Upon admission,serum levels of sTREM⁃1,ADPN,and PLR were measured in all patients.The petients were then divided into two groups based on the presence or absence of VAP:the VAP group(n=33)and the non⁃VAP group(n=63).The risk factors for VAP were analyzed,and receiver operating characteristic(ROC)curves were used to assess the predictive value of serum sTREM⁃1,ADPN,and PLR for VAP.Results Serum sTREM⁃1 and PLR levels in the VAP group were higher than those in the non⁃VAP group,while ADPN levels were lower than those in the non⁃VAP group(P<0.05).Results from multivariate logistic regression analysis results indicated that elevated serum sTREM⁃1 and PLR levels were risk factors for VAP in patients undergoing mechanical ventilation after surgery for traumatic brain injury,whereas elevated ADPN levels were protective factors(P<0.05).The combination of sTREM⁃1,ADPN,and PLR had an AUC of 0.921,sensitivity of 0.903,and specificity of 0.938 for predicting VAP,all of which were higher than those of using a single indicator(P<0.05).Conclusion Abnormal serum sTREM⁃1,ADPN,and PLR are factors that influence the occurrence of VAP in patients undergoing mechanical ventilation after surgery for traumatic brain injury.These three factors can assist in diagnosing VAP in patients following surgery for traumatic brain injury who require mechanical ventilation.

关 键 词：可溶性髓样细胞触发受体⁃1 脂联素 血小板/淋巴细胞比值 呼吸机相关性肺炎 

分 类 号：R651.15[医药卫生—外科学]