实用医学杂志2025，Vol.41Issue(22)：3552-3557,6.DOI:10.3969/j.issn.1006-5725.2025.22.012
sTREM-1、PCT与MRP8/14对重症肺结核患者急性呼吸窘迫综合征的时序预测价值
Temporal predictive value of sTREM-1,PCT,and MRP8/14 for ARDS in severe pulmonary tuberculosis patients
摘要
Abstract
Objective To investigate the temporal predictive value of soluble triggering receptor expressed on myeloid cells-1(sTREM-1),procalcitonin(PCT),and myeloid-related protein 8/14(MRP8/14)for secondary acute respiratory distress syndrome(ARDS)in patients with severe pulmonary tuberculosis.Methods A retro-spective cohort study was conducted among patients with severe pulmonary tuberculosis admitted between January 2021 and December 2024.Patients were randomly assigned in an 8∶2 ratio to a training set(n=148)and a valida-tion set(n=37).Serum sTREM-1,PCT,and MRP8/14 were extracted from the electronic medical record at three time points:on admission(day 0),day 3,and day 7.Multivariable logistic regression was used to identify risk factors,and predictive performance was evaluated using receiver operating characteristic(ROC)curves.Results A total of 185 patients were included.In the training set(n=148),27 developed ARDS and 121 did not;in the validation set(n=37),7 developed ARDS and 30 did not.In the training set,serum sTREM-1,PCT,and MRP8/14 levels showed significant temporal changes(P<0.05).At admission,day 3,and day 7,levels of sTREM-1,PCT,and MRP8/14 were higher in the ARDS group than in the non-ARDS group(all P<0.05).At each time point,sTREM-1,PCT,and MRP8/14 were independently associated with the development of ARDS(P<0.05).In the training set,the combination of sTREM-1,PCT,and MRP8/14 at admission yielded the largest area under the ROC curve[AUC=0.976;95%confidence interval(CI),0.952～1.000],with a sensitivity of 88.9%and a specificity of 98.3%.In the validation set,the same combination achieved an AUC of 0.957(95%CI,0.895～1.000),with a sensitivity of 100.0%and a specificity of 86.7%.Conclusion Dynamic changes in sTREM-1,PCT,and MRP8/14 provide temporal predictive value for ARDS in patients with severe pulmonary tuberculosis,and the combined assessment improves early warning accuracy.关键词
重症肺结核/急性呼吸窘迫综合征/可溶性髓样细胞触发受体-1/降钙素原/髓系相关蛋白8/14/预测Key words
severe pulmonary tuberculosis/acute respiratory distress syndrome/sTREM-1/procal-citonin/MRP8/14/prediction分类
临床医学引用本文复制引用
邓默,贾米山,田彦卿,郑志清,王辉,韩娜..sTREM-1、PCT与MRP8/14对重症肺结核患者急性呼吸窘迫综合征的时序预测价值[J].实用医学杂志,2025,41(22):3552-3557,6.基金项目
河北省医学科学研究课题计划(编号:20231506) （编号:20231506）
