标题：无创呼吸机治疗的重症肺炎并发呼吸衰竭患者血清 sTREM-1、SP-D、EVLWI水平变化及其临床意义

      作者：易欣，王华，吴柳春    三峡大学第三临床医学院·国药葛洲坝中心医院急诊科，湖北 宜昌 443002

      卷次： 2023年34卷3期

      【摘要】 目的 探究采用无创呼吸机治疗的重症肺炎并发呼吸衰竭患者血清可溶性髓系细胞触发受体-1(sTREM-1)、肺表面活性蛋白D (SP-D)、监测血管外肺水指数(EVLWI)水平变化及其临床意义。方法 回顾性分析2018年6月至2021年6月在三峡大学第三临床医学院采用无创呼吸机治疗的80例重症肺炎并发呼吸衰竭患者的诊疗资料，根据治疗效果分为有效组62例和无效组18例。比较两组患者的血清 sTREM-1、SP-D及EVLWI水平，采用Logistic回归分析法分析影响重症肺炎并发呼吸衰竭患者应用无创呼吸机治疗效果的因素。结果 有效组患者的血清 sTREM-1、SP-D水平及EVLWI分别为(40.21±12.36) ng/L、(94.38±20.76) μg/L、(10.42±2.65) mL/kg，明显低于无效组的 (61.97±17.28) ng/L、(110.51±23.09) μg/L、(12.13±2.80) mL/kg，差异均有统计学意义(P<0.05)；经Logistic回归分析结果显示，sTREM-1、SP-D、EVLWI均为影响重症肺炎并发呼吸衰竭患者无创呼吸机治疗效果的相关因素(P<0.05)。结论 采用无创呼吸机治疗重症肺炎并发呼吸衰竭患者的 sTREM-1、SP-D、EVLWI水平变化明显，上述三项指标均为影响无创呼吸机治疗效果的影响因素。
      【关键词】 重症肺炎；呼吸衰竭；无创通气；可溶性髓系细胞触发受体-1；肺表面活性蛋白D；血管外肺水指数
      【中图分类号】 R563.1 【文献标识码】 A 【文章编号】 1003—6350（2023）03—0326—04

Changes of serum soluble myeloid cell trigger receptor-1, surfactant protein D, and extravascular lung waterindex levels in patients with severe pneumonia complicated with respiratory failure treated by non-invasiveventilator and their clinical significance.
YI Xin, WANG Hua, WU Liu-chun. Department of Emergency, the ThirdClinical Medical College of China Three Gorges University·Sinopharm Gezhouba Central Hospital, Yichang 443002, Hubei,CHINA
【Abstract】 Objective To explore the changes of serum soluble myeloid cell trigger receptor-1 (sTREM-1),pulmonary surfactant protein D (SP-D), and extravascular lung water index (EVLWI) in patients with severe pneumoniacomplicated with respiratory failure treated by non-invasive ventilator and their clinical significance. Methods Theclinical data of 80 patients with severe pneumonia complicated with respiratory failure treated with non-invasive ventila-tor in the Third Clinical Medical College of China Three Gorges University from June 2018 to June 2021 were retrospec-tively analyzed. According to the curative effect, they were divided into the effective group (n=62) and the ineffectivegroup (n=18). The levels of serum sTREM-1, SP-D, and EVLWI were compared between the two groups. Logistic regres-sion analysis was used to analyze the factors affecting the effect of non-invasive ventilator on patients with severe pneumo-nia complicated with respiratory failure. Results The sTREM-1, SP-D, EVLWI levels in the effective group were(40.21±12.36) ng/L, (94.38±20.76) μg/L, (10.42±2.65) mL/kg, which were significantly lower than (61.97±17.28) ng/L,(110.51±23.09) μg/L, (12.13±2.80) mL/kg in the ineffective group (P<0.05). The results of Logistic regression analysisshowed that sTREM-1, SP-D, and EVLWI were all related factors affecting the effect of non-invasive ventilator treat-ment in patients with severe pneumonia complicated with respiratory failure (P<0.05). Conclusion The levels ofSTREM-1, SP-D, and EVLWI in patients with severe pneumonia complicated with respiratory failure treated withnon-invasive ventilator have obvious changes, and the above three indicators have certain value in predicting the progno-sis of patients.
      【Key words】 Severe pneumonia; Respiratory failure; Noninvasive ventilation; Soluble triggering receptor ex-pressed on myeloid cells-1; Surfactant protein D; Extracascular lung water index