尿源性感染导致脓毒血症患者血清sTREM-1的检测评价

发布时间：2018-02-09 11:48

  本文关键词： 髓样细胞触发受体 尿源性脓毒血症 诊断 预后　出处：《中华医院感染学杂志》2017年16期 　论文类型：期刊论文

【摘要】：目的探讨血清髓样细胞触发受体1(sTREM-1)对尿源性脓毒血症患者的检测价值。方法选取2013年1月-2016年1月医院泌尿外科收治的114例腔镜手术后尿源性脓毒血症患者为研究组,另选同期医院行腔镜手术未发生尿源性脓毒血症患者100例为对照组;入院24h后、术后1h、术后1、3、7d检测sTREM-1、降钙素原(PCT)、C-反应蛋白(CRP)、白介素6(IL-6)水平;同时根据患者入院24h内各项指标的最差值进行急性生理及慢性健康评分标准Ⅱ(APACHEⅡ)评分,记录两组患者30d内存活情况。结果入院24h后、术后1h、术后1、3、7d研究组sTREM-1均显著高于对照组(P0.05);与PCT、CRP和IL-6相比,sTREM-1诊断尿脓毒血症的敏感性、特异性、阳性预测值和阴性预测值均较高;Spearman相关性分析结果显示,sTREM-1(r=0.859,P0.01)、PCT(r=0.732,P0.01)、CRP(r=0.502,P=0.025)和IL-6(r=0.431,P=0.032)与APACHEⅡ均存在明显正相关性;114例尿源性脓毒血症患者30d内死亡31例,病死率为27.19%;死亡组sTREM-1、PCT、CRP和IL-6峰值浓度均显著高于存活组(P0.05);sTREM-1浓度与尿源性脓毒血症死亡患者生存时间的相关性分析结果显示,sTREM-1峰值浓度(r=-0.651,P0.01)与预后呈负相关。结论 sTREM-1在尿源性脓毒血症早期诊断、病情评估和预后判断中具有指导意义。
[Abstract]:Objective to investigate the value of serum myeloid cell trigger receptor (TREM-1) in the detection of urogenic sepsis. Methods 114 patients with urogenic sepsis treated in urology from January 2013 to January 2016 were selected as study group. In the same period, 100 patients with urogenic sepsis were selected as the control group, the levels of sTREM-1, PCTC-reactive protein and interleukin-6 (IL-6) were detected at 24 hours after admission, 1 hour after operation and 1 day 3 days after operation. At the same time, according to the worst value of each index within 24 hours after admission, the acute physiological and chronic health scoring criteria 鈪，

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