标题：可溶性髓样细胞触发受体-1在多器官功能障碍综合征早期诊断中的意义

      作者：陈月馨 1，李爱东 1，郭 琦 2，黄晨达 3，张贵昌 4
    (深圳市福田区人民医院康复医学科 1、呼吸科 2、重症医学科 3、急诊科 4，广东 深圳 518033)

      卷次： 2015年26卷3期

      【摘要】 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。

      【关键词】 多器官能障碍综合征；可溶性髓样细胞触发受体-1；早期诊断

      【中图分类号】 R442.8 【文献标识码】 A 【文章编号】 1003—6350（2015）03—0339—04


Early diagnostic value of soluble triggering receptor expressed on myeloid cells-1 in multiple organ dysfunction
syndrome.
CHEN Yue-xin 1, LI Ai-dong 1, GUO Qi 2, HUANG Chen-da 3, ZHANG Gui-chang 4. Department of
Rehabilitation Medicine1, Pneumology 2, Intensive Care Unit 3, Emergency 4, People's Hospital of Futian District of
Shenzhen, Shenzhen 518033, Guangdong, CHINA

【Abstract】 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 evaluation
Ⅱ(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.

      【Key words】 Multiple organ dysfunction syndrome; Soluble triggering receptor expressed on myeloidcells-1;