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

doi:10.3969/j.issn.1006-6233.2019.09.011

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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.

Key words： Sepsis Soluble myeloid-like trigger receptor-1 Endothelial cell-specific molecule-1 Procalcitonin

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	XIE Mingfeng

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XIE Mingfeng. Clinical Value of Combined Detection of sTREM-1 ESM-1 and PCT in Early Diagnosis and Prognosis of Sepsis[J]. HeBei Med, 2019, 25(9): 1451-1455.

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2019.09.011 OR http://www.hbyxzzs.cn/EN/Y2019/V25/I9/1451

[1] Peters E, Antonelli M, Wittebole X, et al.A worldwide multicentre evaluation of the influence of deterioration or improvement of acute kidney injury on clinical outcome in critically ill patients with and without sepsis at ICU admission: results from The Intensive Care Over Nations audit[J]. Crit Care, 2018, 22(1):188.
[2] Jones C L, Dupree M, Hutchison I, et al.Personalities, Preferences and Practicalities: Educating Nurses in Wound Sepsis in the British Hospital, 1870-1920[J]. Soc Hist Med, 2018, 31(3):577~604.
[3] Aydemir C, Aydemir H, Kokturk F, et al.The cut-off levels of procalcitonin and C-reactive protein and the kinetics of mean platelet volume in preterm neonates with sepsis[J]. BMC Pediatr, 2018, 18(1):253.
[4] Alkan O S, Ozer E A, Ilhan O, et al.Diagnostic value of urine soluble triggering receptor expressed on myeloid cells (sTREM-1) for late-onset neonatal sepsis in infected preterm neonates[J].Int Med Res, 2018, 46(4):1606~1616.
[5] 顾梅,朱娇玉.血必净注射液联合参麦注射液对脓毒症急性肺损伤患者疗效及血清HMGB1、sTREM-1的影响[J].中国中医急症,2017,26(11):1907~1910.
[6] Pauly D, Hamed S, Behnes M, et al.Endothelial cell-specific molecule-1/endocan: Diagnostic and prognostic value in patients suffering from severe sepsis and septic shock[J]. J Crit Care, 2016, 31(1):68~75.
[7] De Freitas C N, Gaudet A, Portier L, et al. Endocan, sepsis, pneumonia, and acute respiratory distress syndrome[J]. Crit Care. 2018, 22(1): 280.
[8] Mustafic S, Brkic S, Prnjavorac B, et al.Diagnostic and prognostic value of procalcitonin in patients with sepsis[J]. Med Glas (Zenica), 2018, 15(2):93~100.
[9] Merker M, Bolliger R, Schuetz P.Procalcitonin-guided decision-making results in a significant reduction of antibiotic therapy and hospital stay in neonates with suspected early-onset sepsis[J]. BMJ Evid Based Med, 2018, 23(4):154~155.
[10] Thomas-Ruddel D O, Poidinger B, Kott M, et al.Influence of pathogen and focus of infection on procalcitonin values in sepsis patients with bacteremia or candidemia[J]. Crit Care, 2018, 22(1):128.