Xie J, Zhang X H, Zhu W Y
Department of Geriatrics, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
Department of Emergency Medicine, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China.
Genet Mol Res. 2015 May 11;14(2):4716-23. doi: 10.4238/2015.May.11.4.
We examined the value of serum procalcitonin (PCT), C-reactive protein (CRP), soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) for predicting the survival of patients with early-onset stroke associated pneumonia (EOP). A total of 207 stroke patients were enrolled, and 91 developed EOP. Upon admission, serum PCT, CRP, sTREM-1 levels, clinical pulmonary infection score, and Acute Physiology and Chronic Health Evaluation II score were all significantly higher in patients with EOP than in those without EOP (P < 0.05). Of the 91 patients who developed EOP, 39 (42.9%) died (non-survivors) within 28 days. The Acute Physiology and Chronic Health Evaluation II score on admission was significantly higher in non-survivors than in survivors (P < 0.05). Serum PCT and sTREM-1 levels were slightly elevated on days 1, 3, and 5 in non-survivors and gradually decreased in survivors. Serum PCT, sTREM-1, and CRP levels were all significantly higher in non-survivors than in survivors on days 1, 3, and 5 (P < 0.05). The sensitivity and specificity of PCT for predicting the outcome of EOP were 84.6 and 71.2%, the sensitivity and specificity of sTREM-1 were 71.8 and 92.3%, and the sensitivity and specificity of sTREM-1 combined with PCT were 74.4 and 96.2%. Serum PCT combined with sTREM-1 accurately predicted the outcome of EOP patients, and dynamic monitoring of serum PCT and sTREM-1 levels is necessary.
我们研究了血清降钙素原(PCT)、C反应蛋白(CRP)、髓系细胞表面可溶性触发受体-1(sTREM-1)对预测早发性卒中相关性肺炎(EOP)患者生存情况的价值。共纳入207例卒中患者,其中91例发生EOP。入院时,EOP患者的血清PCT、CRP、sTREM-1水平、临床肺部感染评分及急性生理与慢性健康状况评分II均显著高于未发生EOP的患者(P<0.05)。在91例发生EOP的患者中,39例(42.9%)在28天内死亡(非幸存者)。非幸存者入院时的急性生理与慢性健康状况评分II显著高于幸存者(P<0.05)。非幸存者在第1、3和5天血清PCT和sTREM-1水平略有升高,而幸存者则逐渐下降。在第1、3和5天,非幸存者的血清PCT、sTREM-1和CRP水平均显著高于幸存者(P<0.05)。PCT预测EOP结局的敏感性和特异性分别为84.6%和71.2%,sTREM-1的敏感性和特异性分别为71.8%和92.3%,sTREM-1与PCT联合检测的敏感性和特异性分别为74.4%和96.2%。血清PCT与sTREM-1联合能准确预测EOP患者的结局,动态监测血清PCT和sTREM-1水平很有必要。