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动态血清 sCD163、sTREM-1、PCT 和 CRP 在鉴别脓毒症、严重程度评估和预后预测中的诊断价值。

Diagnostic value of dynamics serum sCD163, sTREM-1, PCT, and CRP in differentiating sepsis, severity assessment, and prognostic prediction.

机构信息

Department of Respiratory Medicine, Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing 100853, China.

出版信息

Mediators Inflamm. 2013;2013:969875. doi: 10.1155/2013/969875. Epub 2013 Jul 1.

Abstract

OBJECTIVE

To describe the dynamics changes of sCD163, soluble serum triggering receptor expressed on myeloid cells-1 (sTREM-1), procalcitonin (PCT), and C-reactive protein (CRP) during the course of sepsis, as well as their outcome prediction.

PATIENTS AND METHODS

An SIRS group (30 cases) and a sepsis group (100 cases) were involved in this study. Based on a 28-day survival, the sepsis was further divided into the survivors' and nonsurvivors' groups. Serum sTREM-1, sCD163, PCT, CRP, and WBC counts were tested on days 1, 3, 5, 7, 10, and 14.

RESULTS

On the ICU admission, the sepsis group displayed higher levels of sTREM-1, sCD163, PCT, and CRP than the SIRS group (P < 0.05). Although PCT and sTREM-1 are good markers to identify severity, sTREM-1 is more reliable, which proved to be a risk factor related to sepsis. During a 14-day observation, sCD163, sTREM-1, PCT, and SOFA scores continued to climb among nonsurvivors, while their WBC and CRP went down. Both sCD163 and SOFA scores are risk factors impacting the survival time.

CONCLUSION

With regard to sepsis diagnosis and severity, sTREM-1 is more ideal and constitutes a risk factor. sCD163 is of a positive value in dynamic prognostic assessment and may be taken as a survival-impacting risk factor.

摘要

目的

描述脓毒症过程中 sCD163、可溶性髓系细胞触发受体-1(sTREM-1)、降钙素原(PCT)和 C 反应蛋白(CRP)的动态变化及其对预后的预测价值。

患者和方法

本研究纳入了全身炎症反应综合征(SIRS)组(30 例)和脓毒症组(100 例)。根据 28 天的生存情况,脓毒症组进一步分为存活组和死亡组。在第 1、3、5、7、10 和 14 天检测血清 sTREM-1、sCD163、PCT、CRP 和白细胞计数。

结果

脓毒症组在入住 ICU 时的 sTREM-1、sCD163、PCT 和 CRP 水平均高于 SIRS 组(P<0.05)。虽然 PCT 和 sTREM-1 是识别严重程度的良好标志物,但 sTREM-1 更可靠,被证明是与脓毒症相关的危险因素。在 14 天的观察期间,死亡组的 sCD163、sTREM-1、PCT 和 SOFA 评分持续升高,而白细胞计数和 CRP 下降。sCD163 和 SOFA 评分均是影响生存时间的危险因素。

结论

sTREM-1 对脓毒症的诊断和严重程度更有意义,是一个危险因素。sCD163 在动态预后评估中具有积极价值,可作为影响生存的危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dfc/3713373/e04cda8d081a/MI2013-969875.001.jpg

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