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目的探讨可溶性髓细胞表达触发受体1(soluble triggering receptor expressed on myeloid cells,sTREM-1)在儿科社区获得性肺炎中的检测及临床价值。方法选取60例患有肺炎的住院患儿(细菌性肺炎31例,非细菌性肺炎患儿29例),以健康同龄人作为对照组。检测外周血中sTREM-1、血清前降钙素(PCT)、C反应蛋白(CRP)及白细胞计数(WBC)的表达水平;检测比较细菌性肺炎患儿治疗前后sTREM-1、PCT、CRP水平及变化规律;检测重症及非重症肺炎患儿sTREM-1、PCT、CRP水平。结果 1)细菌性肺炎组血sTREM-1水平(36.36±8.88)μg/L高于非细菌性肺炎组(16.86±1.83)μg/L及健康对照组(16.27±1.97)μg/L(P<0.05),而非细菌性肺炎组sTREM-1与健康对照组差异无统计学意义(P>0.05)。2)重症肺炎患儿血sTREM-1(61.18±13.72)μg/L高于非重症肺炎组(33.97±9.21)μg/L;非重症肺炎组(33.97±9.21)μg/L高于健康对照组(16.27±1.97)μg/L,差异均有统计学意义(P<0.05)。3)细菌性肺炎组血PCT、CRP、WBC高于非细菌性肺炎组及健康对照组(P<0.05),重症肺炎组高于非重症肺炎组(P<0.05)。4)细菌性肺炎组患儿治疗前后sTREM-1水平呈连续进行性下降(36.36±8.88)μg/L vs.(27.34±6.48)μg/L,(16.38±4.20)μg/L,治疗后接近于正常儿童水平,差异有统计学意义(P<0.05)。而PCT、CRP有所降低,早期下降程度不明显(第3天vs第1天),差异无统计学意义(P>0.05)。结论 sTREM-1是早期鉴别诊断细菌感染性肺炎的重要指标,对指导抗生素的合理使用及病情评估、疗效判断有重要临床参考价值。
Objective To investigate the detection and clinical value of soluble triggering receptor expressed on myeloid cells (sTREM-1) in pediatric community-acquired pneumonia. Methods Sixty hospitalized children with pneumonia (31 cases of bacterial pneumonia and 29 cases of non-bacterial pneumonia) were selected, and their healthy peers were selected as the control group. The levels of sTREM-1, PCT, CRP and WBC in peripheral blood were measured. The levels of sTREM-1, PCT and CRP in children with bacterial pneumonia were measured before and after treatment And the changes of sTREM-1, PCT and CRP levels in children with severe and non-severe pneumonia. Results 1) The serum sTREM-1 level in bacterial pneumonia group (36.36 ± 8.88) μg / L was higher than that in non-bacterial pneumonia group (16.86 ± 1.83) μg / L and healthy control group (16.27 ± 1.97) μg / L 0.05). There was no significant difference between sTREM-1 and healthy controls in non-bacterial pneumonia group (P> 0.05). 2) The serum sTREM-1 (61.18 ± 13.72) μg / L in severe pneumonia children was significantly higher than that in non-severe pneumonia patients (33.97 ± 9.21) μg / L; that in non-severe pneumonia patients (33.97 ± 9.21) μg / L was higher than that in healthy controls (16.27 ± 1.97) μg / L, the difference was statistically significant (P <0.05). 3) The blood PCT, CRP and WBC in bacterial pneumonia group were higher than those in non-bacterial pneumonia group and healthy control group (P <0.05), severe pneumonia group was higher than non-severe pneumonia group (P <0.05). 4) The levels of sTREM-1 in patients with bacterial pneumonia decreased continuously (36.36 ± 8.88) μg / L vs. (27.34 ± 6.48) μg / L, (16.38 ± 4.20) μg / L before and after treatment, In normal children, the difference was statistically significant (P <0.05). The PCT, CRP decreased, the early decline was not significant (3 days vs 1 day), the difference was not statistically significant (P> 0.05). Conclusion sTREM-1 is an important indicator of differential diagnosis of bacterial pneumonia in early stage. It has important clinical reference value to guide rational use of antibiotics and assessment of disease.