Yasuda Takeo, Takeyama Yoshifumi, Ueda Takashi, Shinzeki Makoto, Sawa Hidehiro, Takahiro Nakajima, Kamei Keiko, Ku Yonson, Kuroda Yoshikazu, Ohyanagi Harumasa
Department of Surgery, Kinki University School of Medicine, Osaka-sayama, Japan.
Crit Care Med. 2008 Jul;36(7):2048-53. doi: 10.1097/CCM.0b013e31817b8824.
To determine the contribution of triggering receptor expressed on myeloid cells (TREM)-1 in acute pancreatitis (AP).
Prospective study.
General intensive care unit at Kobe University Hospital.
Forty-eight patients with AP and seven patients as control.
None.
We measured serum concentrations of soluble TREM-1 (sTREM-1) at the time of admission by enzyme-linked immunoadsorbent assay. Serum sTREM-1 levels increased significantly in AP (63 +/- 11 pg/mL) and correlated with Ranson score (R = .628, p < .001) and Acute Physiology and Chronic Health Evaluation II score (R = .504, p < .001). Serum TREM-1 levels were higher in patients with early organ dysfunction (which occurred within 7 days after onset) than those without early organ dysfunction (101 +/- 19 vs. 25 +/- 4 pg/mL, p < .001). Incidences of early organ dysfunction in patients whose serum sTREM-1 levels were < or = 40 and > 40 pg/mL were 17% and 83%, respectively (p < .001). The usefulness of serum sTREM-1 in detecting early organ dysfunction was superior to that of C-reactive protein, interleukin-6, interleukin-8, Ranson score, and Acute Physiology and Chronic Health Evaluation II score. Serum sTREM-1 levels decreased with resolution of early organ dysfunction.
Serum sTREM-1 levels were significantly increased and correlated with disease severity and early organ dysfunction in patients with AP. Serum sTREM-1 level may be a useful marker for early organ dysfunction in AP.
确定髓系细胞触发受体-1(TREM-1)在急性胰腺炎(AP)中的作用。
前瞻性研究。
神户大学医院综合重症监护病房。
48例AP患者和7例作为对照的患者。
无。
我们采用酶联免疫吸附测定法在入院时测量可溶性TREM-1(sTREM-1)的血清浓度。AP患者血清sTREM-1水平显著升高(63±11 pg/mL),并与兰森评分(R = 0.628,p < 0.001)和急性生理与慢性健康状况评分II(R = 0.504,p < 0.001)相关。早期器官功能障碍(发病后7天内出现)患者的血清TREM-1水平高于无早期器官功能障碍的患者(101±19 vs. 25±4 pg/mL,p < 0.001)。血清sTREM-1水平≤40 pg/mL和>40 pg/mL的患者早期器官功能障碍的发生率分别为17%和83%(p < 0.001)。血清sTREM-1在检测早期器官功能障碍方面的效用优于C反应蛋白、白细胞介素-6、白细胞介素-8、兰森评分和急性生理与慢性健康状况评分II。血清sTREM-1水平随早期器官功能障碍的缓解而降低。
AP患者血清sTREM-1水平显著升高,且与疾病严重程度和早期器官功能障碍相关。血清sTREM-1水平可能是AP早期器官功能障碍的有用标志物。