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目的评价可溶性髓样细胞触发性受体-1(sTREM-1)对呼吸机相关性肺炎(VAP)诊断的临床价值,为临床应用提供依据。方法对15例VAP患者分别在治疗前、治疗第5、10天进行C-反应蛋白(CRP)、临床肺感染评分(CPIS)检测;同时用酶联免疫吸附试验(ELISA)方法检测血清sTREM-1、气管内抽吸物(ETA)中sTREM-1的浓度。结果治疗前VAP组CPIS、CRP、血清sTREM-1及气管内抽吸物(ETA)中sTREM-1均高于治疗第5、10天及非VAP组,差异均有统计学意义(均P<0.01);VAP组治疗第10天,CPIS、CRP、血清sTREM-1及ETA中sTREM-1与非VAP组比较,差异无统计学意义;做受试者工作特征曲线(ROC)分析,以治疗前ETA中sTREM-1 172ng/ml为界诊断VAP,其敏感性为86.7%,特异性为84.6%。结论 ETA中sTREM-1对VAP诊断有一定的临床价值,其值以172ng/ml为界,诊断的敏感性和特异性较高;VAP患者在给予抗菌药物治疗后,ETA中sTREM-1迅速下降至正常水平,可作为一个疗效判断的参考指标。
Objective To evaluate the clinical value of soluble myeloid cell-triggered receptor-1 (sTREM-1) in the diagnosis of ventilator-associated pneumonia (VAP) and provide the basis for its clinical application. Methods Fifteen patients with VAP were tested for C-reactive protein (CRP) and clinical lung infection score (CPIS) before treatment and on the 5th and 10th day of treatment respectively. Serum sTREM-1 levels were measured by enzyme linked immunosorbent assay (ELISA) 1. Concentration of sTREM-1 in endotracheal aspirate (ETA). Results Before treatment, the levels of sTREM-1 in CPIS, CRP, serum sTREM-1 and endotracheal aspirates (ETA) in VAP group were significantly higher than those in the 5th, 10th and non-VAP groups (all P < 0.01). There was no significant difference between the sTREM-1 and sTREM-1 levels in CPAP, CRP, serum sTREM-1 and ETA group on the 10th day after treatment in the VAP group. The receiver operating characteristic curve (ROC) In the pre-ETA, sTREM-1 172 ng / ml is a borderline diagnostic VAP with a sensitivity of 86.7% and a specificity of 84.6%. Conclusions sTREM-1 has some clinical value in the diagnosis of VAP in ETA. Its value is 172ng / ml. The sensitivity and specificity of sTREM-1 in diagnosis of VAP are very high. The sTREM-1 in ETA is rapidly decreased after VAP treatment with antibiotics To normal levels, can be used as a reference to determine the efficacy of indicators.