实用肝脏病杂志2024，Vol.27Issue(4)：555-558,4.DOI:10.3969/j.issn.1672-5069.2024.04.016
慢加急性乙型肝炎肝衰竭患者血清CRP和sTREM-1水平变化及其预测继发感染的价值研究
Assessment of bacterial infection by serum CRP and sTREM-1 levels in patients with hepatitis B virus-associated acute-on-chronic liver failure
摘要
Abstract
Objective The purpose of this study was to investigate the diagnostic efficacy of serum C-reactive protein(CRP)and soluble triggering receptor expressed on myeloid cells-1(sTREM-1)levels for secondary infections in patients with hepatitis B virus-associated acute-on-chronic liver failure(HBV-ACLF).Methods 96 consecutive patients with HBV-ACLF were encountered in our hospital between February 2020 and February 2023.Serum CRP and sTREM-1 levels were measured by ELISA.The multivariate Logistic regression analysis was conducted to identify the influencing factors for secondary infections in patients with HBV-ACLF.The diagnostic performance of above parameters was evaluated by using the receiver operating characteristic(ROC)curve.Results 67(69.8%)patients with HBV-ACLF in our series developed secondary infections,and the spontaneous bacterial peritonitis,pulmonary infection,urinary tract infection,biliary tract infection,intestinal infection,and skin and soft tissue infection accounted for 40.3%,31.3%,11.9%,4.5%,4.5%,and 7.5%,respectively;the model of end-stage liver disease score and chronic liver failure sequential organ failure assessment score in patients with infection were(15.7±3.0)and(8.5±1.1),both significantly greater than[(12.40±3.00)and(6.1±1.0),P<0.05]in patients without infection;serum CRP and sTREM-1 levels in patients with infection were(52.2±4.6)mg/L and(29.9±5.8)pg/mL,both much higher than[(10.1±3.3)mg/L and(13.3±4.1)pg/mL,P<0.05]in those without;the Logistic regression analysis showed that the international normalization ratio,serum CRP,sTREM-1 and procalcitonin levels were all the independent risk factors for secondary infection(P<0.05);the ROC analysis demonstrated that the AUC was0.906,with the sensitivity of 98.5%and the specificity of 82.8%,when serum CRP and sTREM-1 level combination was applied to predict the existence of infection,much superior to any parameter alone(P<0.05).Conclusion The surveillance of serum CRP and sTREM-1 level could help diagnose the secondary infections in patients with HBV-ACLF,which needs further clinical investigation.关键词
慢加急性肝衰竭/C反应蛋白/可溶性髓系细胞触发受体-1/感染/诊断Key words
Acute-on-chronic liver failure/C-reactive protein/Soluble triggering receptor expressed on myeloid cells-1/Secondary infection/Diagnosis引用本文复制引用
柯海霞,张娇珍,蒙夏玲,许政衡,邓丕豪..慢加急性乙型肝炎肝衰竭患者血清CRP和sTREM-1水平变化及其预测继发感染的价值研究[J].实用肝脏病杂志,2024,27(4):555-558,4.基金项目
海南省自然科学基金面上项目(编号:821MS168) （编号:821MS168）
