摘要
目的探讨多发伤患者外周血血清降钙素原(PCT)、肿瘤坏死因子α(TNF-α)和可溶性髓样细胞触发受体-1(sTREM-1)与严重多发伤后多器官功能障碍综合征(MODS)的相关性。方法 93例多发伤患者按治疗过程中有无发生MODS分为MODS组和非MODS组。MODS患者按照其预后分为死亡组与存活组。采用ELISA法测定伤后及20例健康对照者的血清PCT、TNF-α及sTRME-1的含量,并应用受试者工作特征曲线(ROC曲线)进行统计学分析。结果与对照组相比,多发伤患者血清PCT、TNF-α和sTREM-1伤后均出现不同程度的升高(P<0.01);MODS组与非MODS组比较,各项指标均有统计学差异(P<0.01)。PCT、TNF-α和sTREM-1的ROC曲线下面积分别为0.904、0.687和0.907。死亡组与存活组比较,PCT和sTREM-1水平存在统计学差异(P<0.01),而TNF-α含量无差异(P>0.05)。PCT、TNF-α和sTREM-1诊断MODS的灵敏度分别为80.0%、77.1%、82.9%,特异性分别为79.3%、60.3%、87.9%。sTREM-1与PCT、TNF-α正相关(r分别为0.907、0.515,P均<0.05)。结论 sTREM-1对严重多发伤后预警MODS的诊断性能优于PCT和TNF-α,且对MODS的患者预后具有较好的预测价值。
Objective To investigate the relevance of the soluble triggering receptors expressed on myeloid cells-1 （ sTREM-1 ） with multiple organ dysfunction syndrome （MODS） after severe multiple trauma. Methods A total of 93 pa- tients with multiple trauma were divided into MODS and non-MODS groups. The MODS patients were individed into surviv- al group and death group according to their prognosis. The peripheral serum concentrations of PCT, TNF-α and sTREM-1 were detected by enzyme-linked immunosorbent assay （ELISA） in patients and control group. ROC analysis was per- formed. Results Compared with control group, the serum levels of PCT, TNF-α and sTREM-1 in patients with multiple trauma were increased differently （P 〈 0.01 ）. The levels of PCT, TNF-α and sTREM-1 in MODS group were significantly higher than those in non-MODS group （P 〈 0.01 ）. Area under ROC curve of PCT, TNF-α and sTREM-1 were 0. 904, 0.687 and 0. 907 respectively. The PCT and sTREM-1 levels in death group were higher than those in survival group （ P 〈 0.01 ）. The sensitivities and speeificities of PCT, TNF-α and sTREM-1 were 80.0/79.3, 77.1/60.3 and 82.9/87.9 re- spectively. The correlation coefficients of sTREM-1 with PCT and TNF-ct were 0. 907 and 0.515 （P 〈 0.05 ）. Conclusion The sTREM-1 gets the better of the PCT and TNF-α in the diagnostic performance and in predicting the prognosis of MODS in patients with severe multiple trauma.
出处
《山东医药》
CAS
2013年第4期11-13,共3页
Shandong Medical Journal
基金
沈阳市卫生局科研课题计划项目[沈卫办(2010)66号]
关键词
降钙素原
肿瘤坏死因子Α
可溶性髓样细胞触发受体-1
多发伤
多器官功能障碍综合征
Key words： procalcitonin
tumor necrosis factor alpha
soluble triggering receptors expressed on myeloid cells-l
multiple trauma
multiple organ dysfunction syndrome
