CAJ | 학술논문

目的：研究血清中可溶性髓样细胞触发受体-1(sTREM-1)对危重症患者发生多器官功能障碍综合征(MODS)的预测价值。方法对86例危重症患者在入ICU 24 h内测定血浆中sTREM-1降钙素原(PCT)浓度，并记录其APACHEⅡ评分和SOFA评分。根据24 h后是否出现多器官功能障碍，把患者分为MODS组和非MODS组。应用受试者工作特征曲线(ROC)分析sTREM-1诊断MODS的敏感度与特异度。结果 MODS组血浆sTREM-1、PCT均显著高于非MODS组[sTREM-1(0.551±0.093) ng/L vs (0.292±0.059) ng/L，P<0.05；PCT (1.746±0.064) ng/L vs (1.586±0.046) ng/L，P<0.05]。血浆sTREM-1水平诊断多器官功能障碍综合征的ROC曲线下面积为0.77，以0.15 ng/L为诊断浓度阈值，sTREM-1早期诊断MODS的敏感性为100%，特异性为65.5%。结论检测血清sTREM-1对MODS的早期诊断有重要的临床意义。
목적：연구혈청중가용성수양세포촉발수체-1(sTREM-1)대위중증환자발생다기관공능장애종합정(MODS)적예측개치。방법대86례위중증환자재입ICU 24 h내측정혈장중sTREM-1강개소원(PCT)농도，병기록기APACHEⅡ평분화SOFA평분。근거24 h후시부출현다기관공능장애，파환자분위MODS조화비MODS조。응용수시자공작특정곡선(ROC)분석sTREM-1진단MODS적민감도여특이도。결과 MODS조혈장sTREM-1、PCT균현저고우비MODS조[sTREM-1(0.551±0.093) ng/L vs (0.292±0.059) ng/L，P<0.05；PCT (1.746±0.064) ng/L vs (1.586±0.046) ng/L，P<0.05]。혈장sTREM-1수평진단다기관공능장애종합정적ROC곡선하면적위0.77，이0.15 ng/L위진단농도역치，sTREM-1조기진단MODS적민감성위100%，특이성위65.5%。결론검측혈청sTREM-1대MODS적조기진단유중요적림상의의。
Objective To evaluate the predictive value of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) concentrations in multiple organ dysfunction syndrome (MODS) in critical patients. Methods A total of 86 critically ill patients in ICU were selected in this study. The level of sTREM-1, procalcitonin (PCT) were examined within 24 hours after admission. All patients were scored by acute physiology and chronic health evaluationⅡ(APACHEⅡ) and sequential organ failure assessment (SOFA). According to whether multiple organ dysfunction oc-curred after 24 hours, patients were divided into multiple organ dysfunction group (MODS group) and non-multiple or-gan dysfunction group (non-MODS group). By the Receiver Operating Characteristic (ROC) analysis, sensitivity and specificity of each parameter were calculated. Results In patients with MODS, the sTREM-1 and PCT in plasma were significantly higher than those in the non-MODS group [sTREM-1:(0.551±0.093) ng/L vs (0.292±0.059) ng/L, P<0.05;PCT:(1.746 ± 0.064) ng/L vs (1.586 ± 0.046) ng/L, P<0.05]. By ROC analysis, the area under ROC curve of sTREM-1 was 0.77. The cut-off value of sTREM-1 in plasma were 0.15 ng/L, with sensitivity and specificity of 100% and 65.5%respectively. Conclusion sTREM-1 is of great clinical significance in early diagnosis of multiple organ dysfunction syndrome.