sTREM-1对脓毒症相关性急性肾损伤的早期诊断价值

发布时间：2018-05-13 11:34

本文选题：可溶性髓样细胞触发受体-1 + 脓毒症　；参考：《中南大学》2013年硕士论文

【摘要】：目的：探讨可溶性髓样细胞触发受体-1(sTREM-1)对脓毒症相关性急性肾损伤的早期诊断作用。方法：收录从2012年8月至2012年12月在中南大学湘雅医院重症医学科(ICU)入住的未并发急性肾损伤的脓毒症患者。收集入室时完善血气分析、生化指标、APACHE II评分等资料,并每日收集患者血清、尿液标本行sTREM-1检测。根据入室后是否发生AKI分为AKI组、非AKI组。AKI组以AKI诊断成立当日计为T0d,诊断成立前两日分别计为T(-1)d, T(-2)d。非AKI组以入室后前三天分别计为T(-2)d, T(-1)d, T0d。比较两组患者尿液sTREM-1、血清sTREM-1、肌酐、GFR、尿量组间及组内的变化。行T(-1)d尿液sTREM-1与血清sTREM-1的相关性分析。行T(-1)d各肾功能指标诊断AKI的ROC曲线分析,评价各指标对脓毒症相关性急性肾损伤的诊断价值。对AKI发生与否行危险因素回归分析。结果：①最终纳入62例患者进行研究。其中男41例,女21例。AKI组患者23例,非AKI组患者39例。②AKI组患者尿液sTREM-1在T(-1)d表达水平较非AKI组有统计学差异(P0.05)。AKI组尿液sTREM-1随时间变化呈升高趋势。血清sTREM-1在T0d升高有统计学意义(P0.05)；③以T-1天制作ROC曲线,得出尿液sTREM-1诊断灵敏度和特异度分别为91.7%和87.5%；曲线下面积为0.906(95%C10.785～1.048,P0.05)；④尿液sTREM-1为AKI发生的危险因素。结论：尿液sTREM-1在脓毒症相关性急性肾损伤患者中表达升高,可用于肾损伤的早期诊断,且具有较高的诊断效能,可作为脓毒症相关性急性肾损伤早期诊断的新型生物标记物。
[Abstract]:Objective: to investigate the early diagnostic effect of soluble myeloid cell trigger receptor-1 TREM-1 on septic-associated acute renal injury. Methods: from August 2012 to December 2012, patients with sepsis without acute renal injury were enrolled in the Department of intensive Medicine, Xiangya Hospital, Central South University. The data of blood gas analysis, biochemical index and Apache II score were collected, and the serum and urine samples were collected daily for sTREM-1 detection. According to whether AKI occurred or not, AKI group was divided into two groups: non AKI group. AKI group was counted as T 0 d on the day of AKI diagnosis, and 2 days before the diagnosis. In the non-AKI group, the first three days after entering the room were divided into three groups: Th 2 d, T 1 D, T 0 d. The changes of urine sTREM-1, serum sTREM-1, creatinine GFR and urine volume were compared between the two groups. The correlation between urine sTREM-1 and serum sTREM-1 was analyzed. To evaluate the diagnostic value of ROC curve in the diagnosis of acute renal injury associated with sepsis. The risk factors of AKI were analyzed by regression analysis. Results the study was carried out in 62 patients. Among them, there were 41 males, 21 females, 23 patients in AKI group, 39 patients in non-AKI group and 39 patients in non-AKI group. There was a significant difference in the expression of urinary sTREM-1 between the two groups compared with that in non-AKI group (P0.05. AKI group). The urinary sTREM-1 level in Aki group was higher than that in non-AKI group (P 0.05). The increase of serum sTREM-1 in T0 day was statistically significant. The ROC curve was made on T-1 day. The diagnostic sensitivity and specificity of urine sTREM-1 were 91.7% and 87.5%, respectively, and the area under the curve was 0.906 (950.785 ~ 1.048%, P 0.05). The urine sTREM-1 was the risk factor of AKI. Conclusion: urine sTREM-1 expression in patients with septic associated acute renal injury can be used as a new biomarker for early diagnosis of septic associated acute renal injury.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R459.7

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