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血清iNOS、TREM-1、IL-1Ra表达与细菌感染性肠炎患者病情严重程度的关系及其临床意义研究梁丹红;梁民联;黄换桂;王家华;郑一沣【期刊名称】《中国现代医学杂志》【年(卷),期】2024(34)11【摘要】目的探究细菌感染性肠炎患者血清诱导型一氧化氮合酶(iNOS)、髓样细胞触发受体-1(TREM-1)和白细胞介素-1受体拮抗剂(IL-1Ra)表达的临床意义。
方法前瞻性选取2021年2月—2023年2月广州中医药大学东莞医院收治的120例细菌感染性肠炎患者为研究对象。
采集患者粪便标本,分析感染病原菌的病原学特点;根据病情严重程度将患者分为轻度组28例、中度组79例和重度组13例。
另选取同期本院体检的健康体检者60例为对照组。
比较各组炎症因子[血清降钙素原(PCT)、C反应蛋白(CRP)]、iNOS、TREM-1、IL-1Ra水平;采用Pearson相关分析iNOS、TREM-1、IL-1Ra与炎症因子水平的相关性;采用受试者工作特征(ROC)曲线分析血清iNOS、TREM-1、IL-1Ra对重度细菌感染性肠炎的诊断价值。
结果120例细菌感染性肠炎患者共检出176株病原菌,其中氏阳性菌38株(21.59%),革兰阴性菌138株(78.41%)。
4组血清PCT、CRP、iNOS、TREM-1、IL-1Ra水平比较,差异均有统计学意义(P<0.05);重度组、中度组、轻度组和对照组依次降低(P<0.05)。
Pearson相关性分析结果显示,iNOS、TREM-1、IL-1Ra水平与PCT、CRP水平均呈正相关(P<0.05)。
ROC曲线分析结果显示,iNOS最佳截断值为50.07 ng/L,诊断重度细菌感染性肠炎的敏感性和特异性分别为76.92%(95%CI:0.462,0.950)、81.31%(95%CI:0.726,0.882);TREM-1最佳截断值为70.11 pg/mL,诊断的敏感性和特异性分别为84.62%(95%CI:0.546,0.981)、85.05%(95%CI:0.769,0.912);IL-1Ra最佳截断值为271.75 ng/L,诊断的敏感性和特异性分别为92.31%(95%CI:0.640,0.998)、66.36%(95%CI:0.566,0.752)。
可溶性髓系细胞触发受体-1、降钙素原及超敏C反应蛋白在脓毒血症诊断中的价值黄丹【期刊名称】《内科急危重症杂志》【年(卷),期】2017(023)001【摘要】目的:探讨可溶性髓系细胞触发受体-1(sTREM-1)、降钙素原(PCT)及超敏C反应蛋白(hs-CRP)在脓毒血症诊断中的价值.方法:选取84例脓毒血症患者作为脓毒血症组.其中根据生存情况又分为死亡组27例,生存组57例;另选同期36例非脓毒血症患者作为对照组,运用ELISA法检测所有患者血浆sTREM-1和PCT水平,运用免疫比浊法检测所有患者血浆hs-CRP水平,运用序贯器官衰竭估计评分(SOFA)对患者进行评分,并比较组间差异.结果:脓毒血症组患者的血浆sTREM-1、PCT、hs-CRP以及SOFA评分均显著高于对照组(P＜0.01);脓毒血症患者各亚组间的血浆sTREM-1、PCT水平差异显著(P＜0.01),而组间hs-CRP水平无显著差异(P＞0.05);sTREM-1、PCT、SOFA评分和hs-CRP诊断脓毒血症的曲线下面积(AUC)由高到低分别为0.92、0.85、0.67、0.55,hs-CRP诊断脓毒血症价值不高;死亡组患者的血浆sTREM-1、PCT水平随时间推移,变化不大(P＞0.05),生存组患者第4、7天的血浆sTREM-1、PCT水平显著低于死亡组(P＜0.05),生存组和死亡组hs-CRP水平在各时间点无差异(P＞0.05);脓毒血症组的sTREM-1、PCT与SOFA评分之间呈正相关性关系(r分别为0.46、0.32,均P=0.01),而hs-CRP与SO-FA无显著相关性(P＞0.05).结论:血浆sTREM-1、PCT水平在脓毒血症患者的早期诊断方面具有更高的临床意义.%Objective:To explore the value of soluble triggering receptor expression on myeloid cell-1 (sTREM-1),procalcitonin(PCT) and high sensitive C-reactive protein (hs-CRP) in the diagnosis of sepsis.Methods:Eighty-four children with sepsis from February 2013 to May 2016 in our hospital were selected as sepsis group,and 36 cases of non-sepsis served as control group.The plasma levels of sTREM-1 and PCT were detected by ELISA,and the plasma levels of CRP by turbidimetric inhibition immunoassay.SOFA was used to assess the patient's conditions.Results:The sTREM-1,PCT,hs-CRP and SOFA in the sepsis group were significantly higher than those in the control group (t =8.81,6.92,9.32 and 22.50 respectively;P ＜0.01 for all).The sTREM-1 and PCT levels in subgroups were significantly different (F =16.79 and 30.89;P ＜0.01),but there was no significant difference in hs-CRP (F =1.23,P =0.30).The area under the curve of sTREM-1,PCT,SOFA score and hs-CRP from high to low was 0.92,0.85,0.67,and 055.The diagnostic value of hs-CRP showed no significant.The sTREM-1 and PCT in the death group had no significant change over time (P ＞ 0.05),and the sTREM-1 and PCT in the survival group decreased gradually (P ＜ 0.05).The sTREM-1 and PCT levels in the survival group at 4th and 7th day were significantly lower than those in the death group (P ＜ 0.05),but there was no significant difference between the two groups in hs-CRP (P ＞ 0.05).sTREM-1,PCT and SOFA score were positively correlated with sepsis (r =0.46,0.32;P =0.01,0.01),and there was no significant correlation between hs-CRP and other indexes (r =0.52,P=0.31).Conclusions:sTREM-1 and PCT are more significant in the early diagnosis of sepsis in children.【总页数】4页(P32-34,69)【作者】黄丹【作者单位】成都医学院第一附属医院成都610500【正文语种】中文【中图分类】R631.+2【相关文献】1.可溶性髓系细胞触发受体-1及降钙素原对社区获得性肺炎及肺结核的鉴别诊断价值 [J], 鄢洁;李多;傅玉琼;熊彬2.血清降钙素原、内毒素、可溶性人髓系细胞触发受体-1在肺癌术后并发细菌性肺部感染中的预测价值 [J], 周华锋;齐敏;任等;刘志远;李广志;裴辉3.血清可溶性髓系细胞触发受体-1联合降钙素原及中性粒细胞CD64在脓毒症早期诊断中的价值 [J], 肖强;刘铮;刘鸿;李燕4.可溶性髓系细胞触发受体-1和降钙素原在呼吸道感染诊断中的应用价值 [J], 熊洪海;田中华;尹海淀5.可溶性人髓系细胞触发受体1、可溶性血红蛋白清道夫受体、降钙素原表达水平对肝硬化合并自发性细菌性腹膜炎的诊断价值 [J], 王小芳;张利军因版权原因，仅展示原文概要，查看原文内容请购买。
