Khuchua Eka, Didbaridze Tamar, Ormotsadze Giorgi, Sanikidze Tamar, Pachkoria Elene, Ratiani Levan, Gvajaia Nino, Kupradze Vasil
Department of Anesthesiology and Reanimatology, The First University Clinic of Tbilisi State Medical University, Tbilisi, GEO.
Department of Microbiology, The First University Clinic of Tbilisi State Medical University, Tbilisi, GEO.
Cureus. 2024 Nov 8;16(11):e73310. doi: 10.7759/cureus.73310. eCollection 2024 Nov.
Sepsis and systemic inflammatory response syndrome (SIRS) are significant concerns in intensive care units and contribute significantly to patient mortality. Traditional diagnostic markers such as C-reactive protein (CRP) and procalcitonin (PCT) often lack the sensitivity and specificity needed for early diagnosis and prognosis. Consequently, more reliable biomarkers are needed. This study aimed to evaluate interleukin-6 (IL-6) and soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) as potential biomarkers to improve diagnostic and prognostic capabilities in sepsis and SIRS.
The study comprised 64 patients diagnosed with sepsis and SIRS, admitted to the Critical Care Department of the First University Clinic (Tbilisi, Georgia). Changes in the levels of CRP, PCT, IL-6, sTREM-1, and lactate were monitored over a five-day observation period, with measurements taken on days 0, 1, 2, 3, and 5.
We found a significant logarithmic relationship between sTREM-1 levels and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores (r = 0.922, p < 0.001), suggesting that sTREM-1 could serve as a valuable biomarker for early risk stratification in sepsis. Furthermore, sTREM-1 exhibited strong correlations with IL-6 and lactate levels, underscoring its potential as a predictor of disease severity. While CRP and PCT were more useful in tracking disease progression over time, their baseline levels were less predictive of early outcomes.
Our findings highlight the potential of sTREM-1, IL-6, and lactate as early diagnostic and prognostic markers in sepsis, where sTREM-1 is a critical biomarker for identifying high-risk patients. Further studies with larger cohorts are required to validate these results and explore the sTREM-1 clinical utility in guiding therapeutic interventions in sepsis management.
脓毒症和全身炎症反应综合征(SIRS)是重症监护病房中的重大问题,对患者死亡率有重大影响。传统的诊断标志物,如C反应蛋白(CRP)和降钙素原(PCT),往往缺乏早期诊断和预后所需的敏感性和特异性。因此,需要更可靠的生物标志物。本研究旨在评估白细胞介素-6(IL-6)和髓系细胞表面表达的可溶性触发受体-1(sTREM-1)作为潜在生物标志物,以提高脓毒症和SIRS的诊断和预后能力。
该研究纳入了64例诊断为脓毒症和SIRS的患者,他们被收治于第比利斯格鲁吉亚第一大学诊所的重症监护科。在为期五天的观察期内,监测CRP、PCT、IL-6、sTREM-1和乳酸水平的变化,分别在第0、1、2、3和5天进行测量。
我们发现sTREM-1水平与急性生理与慢性健康状况评分系统II(APACHE II)评分之间存在显著的对数关系(r = 0.922,p < 0.001),这表明sTREM-1可作为脓毒症早期风险分层的有价值生物标志物。此外,sTREM-1与IL-6和乳酸水平呈现出强相关性,凸显了其作为疾病严重程度预测指标的潜力。虽然CRP和PCT在跟踪疾病随时间的进展方面更有用,但它们的基线水平对早期预后的预测性较差。
我们的研究结果突出了sTREM-1、IL-6和乳酸作为脓毒症早期诊断和预后标志物的潜力,其中sTREM-1是识别高危患者的关键生物标志物。需要进行更大样本量的进一步研究来验证这些结果,并探索sTREM-1在指导脓毒症治疗干预中的临床应用。