浙江医学Issue(5)：341-343,380,4.
呼吸机相关性肺炎患者支气管肺泡灌洗液sTREM-1的变化及意义
Changes of sTREM-1 in broncho-alveolar lavage of patient with ventilator associated pneumonia and its significance
摘要
Abstract
Objective To investigate the changes of soluble triggering receptor expressed on myeloid cel s (sTREM-1) in non-bronchoscope broncho-alveolar lavage fluid (BALF) of patients with ventilator associated pneumonia (VAP) and its clinical significance. Methods One hundred and twelve suspected VAP patients were included in the study, the levels of sTREM-1 in BALF,serum C-reactive protein (CRP) and clinical pulmonary infection scores (CPIS) were determined.The dynamic changes of these parameter were observed in 74 VAP patients at d0, 4,7 and 14 of suspected diagnosis, or the day of ventilator weaning or death. Results The levels of BALF sTREM-1, serum CRP and CLIS scores were significant higher in VAP patients compared to non-VAP patients at the day of suspected diagnosis (P<0.01). Receiver operating characteristic (ROC) curve was analyzed, if 153.18pg/ml sTREM-1 in BALF was selected as cut-off point of VAP diagnosis, the sensitivity, specificity and the area of ROC curve was 86.49%, 84.21% and 0.882 respectively. In VAP patients, the levels of BALF sTREM-1 were continuously rose in non-survivor group during d1~d14, although those in survivor group began to decrease on d7 after suspected diagnosis of VAP. There was significant difference between non-survivor and survivor group on the levels of BALF sTREM-1 at the same time point. Correlation analysis shows that the levels of BALF sTREM-1 had positive correlation with APACHEII score (r=0.526, P<0.01). Conclusion 153.18pg/ml of BALF sTREM-1 can be used as a cut-off point for diagnosis of VAP. Monitoring the changes of BALF sTREM-1 may be helpful to predict the severity of disease and to make the prognosis.关键词
可溶性髓系细胞触发受体-1/呼吸机相关性肺炎/微支气管肺泡灌洗Key words
Soluble triggering receptor expressed on myeloid cel-1/Ventilator associated Pneumonia/Non-bron-choscope broncho-alveolar lavage fluid引用本文复制引用
杨向红,孙仁华,陈敏华,张美齐..呼吸机相关性肺炎患者支气管肺泡灌洗液sTREM-1的变化及意义[J].浙江医学,2013,(5):341-343,380,4.基金项目
浙江省卫生厅资助项目(2007B010) （2007B010）
