可溶性髓系细胞触发受体-1动态演变与常规指标预测重症肺炎患者28 d死亡的价值比较

doi:10.13558/j.cnki.issn1672-3686.2024.007.008

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题名	可溶性髓系细胞触发受体-1动态演变与常规指标预测重症肺炎患者28 d死亡的价值比较
其他题名	Value comparison of dynamic evolution of serum trigger receptor expressed myeloid cell-1 and conventional in-dicators for predicting 28 days death in patients with severe pneumonia
作者	傅顺金 1; 廖岐鸣 1; 金剑敏 2
发表日期	2024-07-30
发表期刊	全科医学临床与教育影响因子和分区
语种	中文
原始文献类型	学术期刊
关键词	重症肺炎可溶性髓系细胞触发受体-1 死亡炎症序贯器官衰竭评估血乳酸
其他关键词	severe pneumonia ; trigger receptor expressed myeloid cell-1 ; death ; inflammation ; sequential or-gan failure assessment ; blood lactic acid
摘要	目的探讨重症肺炎可溶性髓系细胞触发受体-1(sTREM-1)的动态演变与常规指标预测治疗28 d死亡风险的临床价值。方法回顾性选择2022年1月至2023年4月金华市人民医院确诊重症肺炎患者共126例为研究对象，所有患者根据指南推荐进行综合治疗，根据治疗28 d的临床结局分为存活组和死亡组。比较两组常规临床资料和sTREM-1动态演变，多因素logistic回归筛选重症肺炎患者治疗28 d死亡的预测因子，Spearman检验进行相关性分析，受试者工作特征（ROC）曲线计算预测因子对重症肺炎患者治疗28 d死亡的曲线下面积（AUC）。结果治疗28 d的临床结局显示，存活组92例和死亡组34例。与存活组比较，死亡组年龄大，入院急性生理与慢性健康评估Ⅱ（APACHEⅡ）评分、序贯器官衰竭评估（SOFA）评分、动脉血乳酸、C反应蛋白（CRP）和降钙素原（PCT）水平升高，机械通气时间延长，而氧合指数降低，差异均有统计学意义（t分别=5.03、26.66、3.86、5.43、23.32、16.66、4.86、-30.21,P均<0.05）。死亡组入院1 d、3 d和7 d的sTREM-1水平，△Q1、△Q2、△Q1%和△Q2%sTREM-1值均明显高于存活组，差异均有统计学意义（t分别=20.33、56.52、89.53、16.66、66.52、19.66、35.56,P均<0.05）。入院SOFA评分、血乳酸、△Q2和△Q2%sTREM-1值升高是28 d死亡的危险因素（OR分别=1.56、1.76、1.86、1.97,P均<0.05）。Spearman检验显示，△Q2和△Q2%sTREM-1值与SOFA评分和血乳酸呈正相关（rs分别=0.66、0.75、0.71、0.82,P均<0.05）。ROC显示，入院SOFA评分、血乳酸、△Q2和△Q2%sTREM-1值预测28 d死亡的AUC分别为0.70、0.78、0.84和0.87,Q2和△Q2%sTREM-1值的预测性能最佳。结论重症肺炎sTREM-1动态演变与28 d死亡风险有关，可成为预测短期临床结局的重要生化标志物，其中△Q2和△Q2%sTREM-1值升高对28 d死亡有较好的预测效能。
其他摘要	Objective To investigate the predictive value of dynamic evolution of serum trigger receptor expressed my-eloid cell-1(sTREM-1)or conventional indicators for death risk after 28 days treatment in patients with severe pneumo-nia.Methods A total of 126 patients with severe pneumonia in Jinhua People's Hospital from January 2022 to April 2023 were selected.All patients were recommended for comprehensive treatments according to the guidelines,and divided into survival group and death group according to the 28 day clinical outcome.The routine clinical datas and dynamic evo-lution of sTREM-1 were compared,predictive factors for 28 day mortality in severe pneumonia patients were screened us-ing multivariate logistic regression,correlation analysis was made using Spearman correlation analysis,the area under the curve(AUC)was calculated of the predictive factors for 28 day mortality in severe pneumonia patients using receiver op-erating curve(ROC).Results The clinical out-come of 28 days of treatment showed that 92 cases were survival and 34 cases death.Compared to the survival group,the age of death group was older,the scores of APACHE Ⅱ and SOFA on admission,the levels of lactic acid in arterial blood,C-reactive protein and procalcitonin were higher,mechanical ventilation time was longer,while oxygenation index was less(t=5.03,26.66,3.86,5.43,23.32,16.66,4.86,-30.21,P＜0.05).The sTREM-1 levels at 1,3 and 7 days after admission,and the values of △Q1,ΔQ2,△Q1%and △Q2%were significantly higher(t=20.33,56.52,89.53,16.66,66.52,19.66,35.56,P＜0.05).Higher admission SOFA score,blood lac-tic acid,△Q2 and △Q2%sTREM-1 values were strong predictors to death after 28 days treatment(OR=1.56,1.76,1.86,1.97,P＜0.05).The △Q2,△Q2%sTREM-1 values were significantly positively correlated with SOFA score and blood lactic acid(rs=0.66,0.75,0.71,0.82,P＜0.05).ROC showed AUC of admission SOFA score,blood lactic acid,△Q2 and △Q2%sTREM-1 value for predicting death after 28 days treatment for severe pneumonia were 0.70,0.78,0.84 and 0.87.The predictive performance of Q2 and △Q2%sTREM-1 values was the best.Conclusion The dynamic evolu-tion of sTREM-1in the early stage of admission for severe pneumonia is closely related to the death risk after 28 days treatment,which could become important biochemical marker for predicting short-term clinical outcome,among them,the increasing of △Q2 and △Q2%value have good predictive effects for death after 28 days treatment.
资助项目	金华市公益性技术应用研究项目（2022-4-167）;
ISSN	1672-3686
卷号	22 期号:07 页码:607-610+633
DOI	10.13558/j.cnki.issn1672-3686.2024.007.008
页数	5
收录类别	CNKI ; 万方
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引用统计
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/217777
专题	第一临床医学院（信息与工程学院）、附属第一医院_急诊医学
作者单位	1.金华市人民医院(温州医科大学附属金华医院)急诊医学中心; 2.金华市人民医院(温州医科大学附属金华医院)血透净化中心
第一作者单位	急诊医学
第一作者的第一单位	急诊医学
推荐引用方式 GB/T 7714	傅顺金,廖岐鸣,金剑敏. 可溶性髓系细胞触发受体-1动态演变与常规指标预测重症肺炎患者28 d死亡的价值比较[J]. 全科医学临床与教育,2024,22(07):607-610+633.
APA	傅顺金, 廖岐鸣, & 金剑敏. (2024). 可溶性髓系细胞触发受体-1动态演变与常规指标预测重症肺炎患者28 d死亡的价值比较. 全科医学临床与教育, 22(07), 607-610+633.
MLA	傅顺金,et al."可溶性髓系细胞触发受体-1动态演变与常规指标预测重症肺炎患者28 d死亡的价值比较".全科医学临床与教育 22.07(2024):607-610+633.