Nasr El-Din Asmaa, Abdel-Gawad Abdelhady Ragab, Abdelgalil Wesam, Fahmy Nahed F
Department of Microbiology and Immunology, Faculty of Medicine, Sohag University, Sohag, Egypt.
Department of Clinical and Chemical Pathology, Faculty of Medicine, Sohag University, Sohag, Egypt.
Infect Drug Resist. 2021 Aug 31;14:3495-3507. doi: 10.2147/IDR.S314237. eCollection 2021.
The purpose of this study was to explore the diagnostic role of sTREM1 in the diagnosis of sepsis and in differentiating between sepsis and systemic inflammatory response syndrome (SIRS). We also aimed to assess the prognostic value of suPAR in comparison to sequential organ-failure assessment (SOFA), acute physiology and chronic health evaluation (APACHE) II scores, and 28-day mortality.
This was a cross-sectional study conducted in the Medical Microbiology and Immunology Department and Central Research Laboratory, Faculty of Medicine, Sohag University from June 2019 to January 2021. The study population was classified into two groups: SIRS (no evidence of infection) and sepsis (with SIRS and evidence of infection). Patients were rated on the SOFA and APACHE II scoring systems at admission and after 7 days. Serum levels of sTREM1 and suPAR were measured by ELISA at the same time points.
CRP and sTREM1 values were significantly higher in the sepsis group than the SIRS group on both days (<0.0001). The area under the curve (AUC) for CRP was 0.87 on the first day and 0.97 on the seventh, while the AUC for sTREM1 was 1.00 and 0.93 on the first and seventh days, respectively. The sensitivity of sTREM1 was 100% and specificity 84% at a cutoff of 49 pg/mL. There was a significantly positive correlation between CRP and sTREM1 values (<0.0001). On the seventh day, nonsurvivors had significantly higher serum levels of suPAR (median 4.9 ng/mL) than survivors (median 2.9 ng/mL; <0.0001). Nonsurvivors also had significantly higher SOFA and APACHE II scores than survivors (<0.0001 and <0.0001, respectively).
sTREM1 can be used as a good indicator for diagnosing sepsis in intensive care-unit patients. suPAR can also be used as a predictor of bad prognosis and poor survival at 7 days following admission.
本研究旨在探讨可溶性髓系细胞触发受体-1（sTREM1）在脓毒症诊断以及区分脓毒症与全身炎症反应综合征（SIRS）中的诊断作用。我们还旨在评估可溶性尿激酶型纤溶酶原激活物受体（suPAR）相较于序贯器官衰竭评估（SOFA）、急性生理与慢性健康状况评分系统（APACHE）II评分以及28天死亡率的预后价值。
这是一项于2019年6月至2021年1月在索哈格大学医学院医学微生物学与免疫学系及中央研究实验室开展的横断面研究。研究人群分为两组：SIRS组（无感染证据）和脓毒症组（伴有SIRS且有感染证据）。患者在入院时及7天后依据SOFA和APACHE II评分系统进行评分。在相同时间点通过酶联免疫吸附测定（ELISA）法检测血清sTREM1和suPAR水平。
脓毒症组的CRP和sTREM1值在两天时均显著高于SIRS组（<0.0001）。CRP的曲线下面积（AUC）在第一天为0.87，第七天为0.97，而sTREM1的AUC在第一天和第七天分别为
1.00和0.９3。当临界值为49 pg/mL时，sTREM1的敏感性为100%，特异性为84%。CRP与sTREM1值之间存在显著正相关（<0.0001）。在第七天，非存活者的血清suPAR水平（中位数4.9 ng/mL）显著高于存活者（中位数2.9 ng/mL；<0.0001）。非存活者的SOFA和APACHE II评分也显著高于存活者（分别为<0.0001和<0.0001）。
sTREM1可作为重症监护病房患者脓毒症诊断的良好指标。suPAR也可作为入院后7天预后不良和生存不佳的预测指标。
