Bopp Christian, Hofer Stefan, Bouchon Axel, Zimmermann Johannes B, Martin Eike, Weigand Markus A
Department of Anesthesiology, University of Heidelberg, Heidelberg, Germany.
Eur J Anaesthesiol. 2009 Jun;26(6):504-7. doi: 10.1097/EJA.0b013e328329afca.
To evaluate plasma levels of soluble TREM-1 (sTREM-1) in patients with systemic inflammatory response syndrome (SIRS), severe sepsis, and septic shock and to determine whether plasma sTREM-1 could be used as a diagnostic and prognostic marker in sepsis in the surgical ICU.
The study was designed as an observational noninterventional clinical study in a surgical ICU of a university hospital. For this, 65 intensive care patients were enrolled within the first 24 h after onset of SIRS (n = 11), severe sepsis (n = 39) or septic shock (n = 15). In addition, 21 healthy volunteers served as controls. At days 0, 1, and 3 after diagnosis, plasma sTREM-1 was measured by ELISA.
Plasma sTREM-1 concentrations in healthy controls did not significantly differ from those in patients with SIRS, severe sepsis, or septic shock at days 0, 1, and 3. Survivors were defined as septic patients surviving for at least 28 days. There were no differences in plasma sTREM-1 levels between survivors (n = 22) and nonsurvivors (n = 27) on any day.
In this study in patients with SIRS, severe sepsis, or septic shock, plasma sTREM-1 levels were not elevated as compared with healthy controls. Measurement of plasma sTREM-1 did not distinguish between patients with SIRS, severe sepsis, or septic shock or between survivors and nonsurvivors. The suggested role of sTREM-1 as a diagnostic and prognostic marker in sepsis should be carefully verified.
评估全身炎症反应综合征(SIRS)、严重脓毒症及脓毒性休克患者血浆中可溶性髓系细胞触发受体-1(sTREM-1)水平,以确定血浆sTREM-1是否可作为外科重症监护病房(ICU)脓毒症的诊断及预后标志物。
本研究设计为在一所大学医院外科ICU进行的观察性非干预性临床研究。为此,在SIRS(n = 11)、严重脓毒症(n = 39)或脓毒性休克(n = 15)发作后的最初24小时内纳入65名重症监护患者。此外,21名健康志愿者作为对照。在诊断后的第0、1和3天,采用酶联免疫吸附测定法(ELISA)检测血浆sTREM-1。
在第0、1和3天,健康对照组的血浆sTREM-1浓度与SIRS、严重脓毒症或脓毒性休克患者的血浆sTREM-1浓度无显著差异。幸存者定义为存活至少28天的脓毒症患者。在任何一天,幸存者(n = 22)和非幸存者(n = 27)的血浆sTREM-1水平均无差异。
在本研究的SIRS、严重脓毒症或脓毒性休克患者中,与健康对照组相比,血浆sTREM-1水平未升高。血浆sTREM-1的检测无法区分SIRS、严重脓毒症或脓毒性休克患者,也无法区分幸存者和非幸存者。sTREM-1作为脓毒症诊断及预后标志物的作用有待仔细验证。