Department of Anesthesiology and Intensive Therapy, Medical University of Bialystok, Bialystok, Poland.
Department of Neurodegeneration Diagnostics, Medical University of Bialystok, Bialystok, Poland.
Arch Immunol Ther Exp (Warsz). 2018 Aug;66(4):299-306. doi: 10.1007/s00005-017-0499-x. Epub 2017 Dec 27.
Early prognostic prediction of sepsis is essential in adjusting therapeutic protocols to prevent deterioration and reduce mortality. We compared the predictive value of the serum concentration of the soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) for 28-day mortality and for the development of severe sepsis or septic shock on the third day with the levels of interleukin (IL)-6, C-reactive protein (CRP) and procalcitonin (PCT). The study was conducted on 85 patients with sepsis. sTREM-1, CRP, PCT and IL-6 concentrations were measured upon study inclusion (day 0) and on days 1, 2, 3 and 5. APACHE II, SAPS II and SOFA scores were analyzed. The sTREM-1 levels (pg/ml) were higher in non-survivors than in survivors at admission (773 vs. 391, p < 0.001) and on days 1, 2, 3 and 5. In predicting the development of severe sepsis, the highest AUCs were found for PCT (0.744, 95% CI 0.638-0.85) and sTREM-1 (0.664, 95% CI 0.55-0.778); and in septic shock prediction, for PCT (0.766, 95% CI 0.665-0.867) and IL-6 (0.707, 95% CI 0.595-0.819). sTREM-1 positively correlated with APACHE II, SAPS II and SOFA scores. At inclusion, significant AUC for predicting 28-day mortality was 0.772 for the sTREM-1 (95% CI 0.672-0.871), 0.858 for APACHE II (95% CI 0.768-0.948), 0.847 for SAPS II (95% CI 0.733-0.96), 0.806 for SOFA score (95% CI 0.698-0.915). sTREM-1 can early predict the 28-day sepsis mortality, although its effectiveness is lower in comparison with clinical severity scores.
早期预测脓毒症对于调整治疗方案以防止病情恶化和降低死亡率至关重要。我们比较了可溶性髓系细胞触发受体 1（sTREM-1）血清浓度对 28 天死亡率和第 3 天发生严重脓毒症或脓毒性休克的预测价值与白细胞介素（IL）-6、C 反应蛋白（CRP）和降钙素原（PCT）的水平。该研究纳入了 85 例脓毒症患者。在研究纳入时（第 0 天）以及第 1、2、3 和 5 天测量 sTREM-1、CRP、PCT 和 IL-6 浓度。分析了 APACHE II、SAPS II 和 SOFA 评分。入院时，非幸存者的 sTREM-1 水平（pg/ml）高于幸存者（773 vs. 391，p<0.001），第 1、2、3 和 5 天也是如此。在预测严重脓毒症的发生方面，PCT（0.744，95%CI 0.638-0.85）和 sTREM-1（0.664，95%CI 0.55-0.778）的 AUC 最高；在预测脓毒性休克方面，PCT（0.766，95%CI 0.665-0.867）和 IL-6（0.707，95%CI 0.595-0.819）的 AUC 最高。sTREM-1 与 APACHE II、SAPS II 和 SOFA 评分呈正相关。纳入时，sTREM-1 预测 28 天死亡率的 AUC 为 0.772（95%CI 0.672-0.871），APACHE II 为 0.858（95%CI 0.768-0.948），SAPS II 为 0.847（95%CI 0.733-0.96），SOFA 评分为 0.806（95%CI 0.698-0.915），具有显著意义。sTREM-1 可以早期预测 28 天脓毒症死亡率，但其有效性低于临床严重程度评分。
