Abstract：Objective: To observe the combined detection of soluble myeloid trigger receptor-1 (sTREM-1), endothelial cell-specific molecule-1 (ESM-1) and procalcitonin (PCT) in the early diagnosis and prognosis in patient with sepsis. Methods: 136 patients with sepsis in ICU, from January 2015 to December 2017, were selected as sepsis group. In the same period, 56 patients with systemic inflammatory response syndrome (SIRS) who had not developed sepsis in the ICU and 30 healthy people were selected as non-sepsis group and control group. The differences of serum sTREM-1, ESM-1 and PCT levels were compared among sepsis group, non-sepsis group and control group. The analysis of variance was used to compare the serum levels in sepsis patients with different severity. The Spearman correlation analysis was used to compare the indicators. Logistic regression and receiver operating characteristic curve of sTREM-1, ESM-1 and PCT were used to value the efficacy in diagnosing sepsis and predicting prognosis. Results: The serum levels of sTREM-1, ESM-1, and PCT in the sepsis group were significantly higher than those in the non-sepsis group and the control group (P<0.01), whereas levels in the non-sepsis group were significantly higher than those in the control group (P<0.01). The serum sTREM-1, ESM-1, and PCT levels increased in sepsis patients with the severity of sepsis (P<0.01). The serum levels of sTREM-1, ESM-1 and PCT in the death group were significantly higher than those in the survivor group (P<0.01). The serum levels of sTREM-1 in sepsis patients were positively correlated with ESM-1 (r=0.684, P<0.01) and PCT (r=0.716, P<0.01), and the positive correlation between ESM-1 and PCT levels (r= 0.754, P < 0.01). In the predictive diagnosis of sepsis, the area under the curve of the combined detection was 0.957, the sensitivity was 82.4%, and the specificity was 98.2%. It was significantly better than sTREM-1 (Z=4.840, P<0.01), and ESM-1 (Z=4.350, P<0.01) and PCT (Z=4.554, P<0.01), but there was no significant difference in the area under the curve among sTREM-1, ESM-1 and PCT (P>0.05). In predicting the prognosis, the area under the curve of the combined detection was 0.969, the sensitivity was 95.8% and the specificity was 96.9%, it was significantly better than sTREM-1 (Z=3.9923, P<0.01), and ESM-1 (Z=4.487, P<0.01) and PCT (Z=2.617, P<0.01), but there was no significant difference in the area under the curve among sTREM-1, ESM-1 and PCT (P>0.05). Conclusion: sTREM-1, ESM-1 and PCT are involved in the development of sepsis diseases. The combined detection is obviously superior to the detection of single markers. It has important clinical value for early diagnosis and prognosis prediction.
谢鸣峰. 联合检测sTREM-1 ESM-1和PCT在脓毒症早期诊断和预后临床价值[J]. 河北医学, 2019, 25(9): 1451-1455.
XIE Mingfeng. Clinical Value of Combined Detection of sTREM-1 ESM-1 and PCT in Early Diagnosis and Prognosis of Sepsis. HeBei Med, 2019, 25(9): 1451-1455.
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2019, Vol. 25 
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