Kung Chia-Te, Su Chih-Min, Hsiao Sheng-Yuan, Chen Fu-Cheng, Lai Yun-Ru, Huang Chih-Cheng, Lu Cheng-Hsien
Department of Emergency Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan.
Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan.
Diagnostics (Basel). 2021 Oct 25;11(11):1979. doi: 10.3390/diagnostics11111979.
Increased soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) levels have been reported in patients with sepsis. We tested the hypotheses that serum sTREM-1 levels increase in the early phase of sepsis and decrease after sepsis under appropriate treatment and that sTREM-1 levels can predict therapeutic outcomes. One hundred and fifty-five patients prospectively underwent blood samples including biochemical data, sTREM-1, and biomarkers on endothelial dysfunction as well as clinical severity index examinations. Blood samples from Days 1, 4, and 7 after admission were checked. For comparison, 50 healthy subjects were selected as healthy control. Those patients who had sepsis had significantly higher sTREM-1 levels than those of healthy control. sTREM-1 levels positively correlated with biomarkers for endothelial dysfunction (ICAM-1, VCAM-1, and E-selectin) and lactate level as well as clinical severity index (maximum 24 h APACHE score and Sequential Organ Failure Assessment (SOFA) score) upon admission. sTREM-1 concentrations were significantly higher from Day 1 to Day 7 in the non-survivors than in the survivors. A stepwise logistic regression analysis showed only sTREM-1 level and maximum 24 h SOFA score upon admission were significantly associated with fatality. Area under the receiver operating characteristic curve analysis for the diagnostic accuracy of sTREM-1 in sepsis-related fatality gave a value of 0.726, with a cutoff value of 384.6 pg/mL (sensitivity = 80.8% and specificity = 61.5%). sTREM-1 level may be valuable in auxiliary diagnosis, and it can serve as a useful biomarker as a screening service and follow-up therapeutic outcomes in sepsis.
脓毒症患者中已报道髓系细胞触发受体1（sTREM-1）的可溶性水平升高。我们检验了以下假设：脓毒症早期血清sTREM-1水平升高，在适当治疗后脓毒症患者的sTREM-1水平下降，且sTREM-1水平可预测治疗结果。155例患者前瞻性地接受了血液样本检测，包括生化数据、sTREM-1、内皮功能障碍生物标志物以及临床严重程度指数检查。检测入院后第1天、第4天和第7天的血样。作为对照，选择50名健康受试者作为健康对照组。脓毒症患者的sTREM-1水平显著高于健康对照组。入院时，sTREM-1水平与内皮功能障碍生物标志物（细胞间黏附分子-1、血管细胞黏附分子-1和E-选择素）、乳酸水平以及临床严重程度指数（最大24小时急性生理与慢性健康状况评分系统（APACHE）评分和序贯器官衰竭评估（SOFA）评分）呈正相关。非存活者第1天至第7天的sTREM-1浓度显著高于存活者。逐步逻辑回归分析显示，仅入院时的sTREM-1水平和最大24小时SOFA评分与死亡率显著相关。sTREM-1对脓毒症相关死亡率诊断准确性的受试者工作特征曲线下面积分析值为0.726，临界值为384.6 pg/mL（敏感性=80.8%，特异性=61.5%）。sTREM-1水平在辅助诊断中可能具有价值，它可作为脓毒症筛查服务和后续治疗结果的有用生物标志物。
