El Solh Ali A, Akinnusi Morohunfolu E, Peter Misha, Berim Ilya, Schultz Marcus J, Pineda Lilibeth
Western New York Respiratory Research Center, Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, State University of New York at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY, USA.
Intensive Care Med. 2008 Jun;34(6):1012-9. doi: 10.1007/s00134-008-1087-7. Epub 2008 Apr 8.
To investigate the potential role of serum and alveolar soluble triggering receptor expressed on myeloid cells (sTREM-1) as a biological marker of pulmonary aspiration syndromes.
Prospective cohort study.
University-affiliated intensive care unit.
Seventy-five patients with pulmonary aspiration and 13 controls receiving mechanical ventilation.
Blood and bronchoalveolar lavage (BAL) fluid samples were collected on enrollment. Soluble TREM-1 levels were measured by an enzyme-linked immunosorbent assay.
Thirty-eight of 75 participants had documented BAL culture-positive pulmonary aspiration. While circulating levels of sTREM-1 were comparable between those with aspiration syndromes (19.81 +/- 12.09 pg/ml) and controls (15.96 +/- 11.16 pg/ml) (p=0.27), the alveolar levels of sTREM-1 were higher in patients with culture-positive pulmonary aspiration (344.41 +/- 152.82 pg/ml) compared with those culture-negative pulmonary aspiration (142.76 +/- 89.88 pg/ml; p < 0.001). A cut-off value of 250 pg/ml for alveolar sTREM-1 achieved a sensitivity of 65.8% (95% CI 48.6-80.4) and a specificity of 91.9% (95% CI 78.1-98.2) with an area under the curve of 0.87 (95% CI 0.78-0.94).
Alveolar sTREM-1 levels can be a potential biomarker for distinguishing BAL culture-positive from BAL culture-negative pulmonary aspiration.
探讨血清和肺泡中髓样细胞表达的可溶性触发受体（sTREM-1）作为肺误吸综合征生物学标志物的潜在作用。
前瞻性队列研究。
大学附属医院重症监护病房。
75例肺误吸患者和13例接受机械通气的对照者。
入组时采集血液和支气管肺泡灌洗（BAL）液样本。采用酶联免疫吸附测定法测量可溶性TREM-1水平。
75名参与者中有38人记录有BAL培养阳性的肺误吸。虽然误吸综合征患者（19.81±12.09 pg/ml）和对照者（15.96±11.16 pg/ml）的循环sTREM-1水平相当（p = 0.27），但培养阳性的肺误吸患者的肺泡sTREM-1水平（344.41±152.82 pg/ml）高于培养阴性的肺误吸患者（142.76±89.88 pg/ml；p<0.001）。肺泡sTREM-1的截断值为250 pg/ml时，灵敏度为65.8%（95%CI 48.6 - 80.4），特异性为91.9%（95%CI 78.1 - 98.2），曲线下面积为0.87（95%CI 0.78 - 0.94）。
肺泡sTREM-1水平可能是区分BAL培养阳性和BAL培养阴性肺误吸的潜在生物标志物。
