【摘要】：目的： 通過檢測肺部感染患者外周血中可溶性髓樣細胞觸發(fā)型受體-1（sTREM-1）、降鈣素原（PCT）、C-反應(yīng)蛋白（CRP）的水平，觀察sTREM-1在肺部感染中的診斷意義以及在CAP和HAP中是否存在差異，并探討其臨床應(yīng)用價值。 方法： 采用ELISA法檢測試驗組（30例社區(qū)獲得性肺炎患者、18例醫(yī)院獲得性肺炎患者）及對照組（14例彌漫性肺疾病患者）外周血中sTREM-1、PCT、CRP水平，并計算出各項指標的敏感性、特異性及診斷符合率。 結(jié)果： （1）CAP組血清中的sTREM-1（99.71±111.17）pg/ml、PCT（10.26±22.02）ug/ml均明顯高于對照組（P＜0.05）；（2） HAP組血清中的sTREM-1（117.40±134.73）pg/ml、PCT（8.67±9.11）ug/ml均明顯高于對照組（P＜0.05）；（3）CAP組和HAP組血清中的sTREM-1、PCT、CRP無明顯差異（P＞0.05）；（4）根據(jù)ROC曲線得出sTREM-1的最佳閾值為38.13pg/ml，以此為標準CAP診斷的敏感性為0.900，特異性為0.786，診斷符合率為0.864，高于同組CRP（P＜0.05）；其診斷的敏感性和診斷符合率高于同組PCT（P＜0.05）；HAP診斷的敏感性為0.889，，特異性為0.786，診斷符合率為0.844，高于同組CRP（P＜0.05）；其診斷的敏感性和診斷符合率高于同組PCT（P＜0.05）；sTREM-1的特異性為0.786，與PCT無明顯差異；（5）CAP組及HAP組中sTREM-1+PCT聯(lián)合檢測的敏感性、特異性和診斷符合率高于sTREM-1單獨檢測（P＜0.05）。 結(jié)論： 1、CAP、 HAP血清中的sTREM-1、PCT、CRP的水平明顯升高，sTREM-1和PCT的敏感性、特異性和診斷符合率優(yōu)于CRP；sTREM-1的敏感性和診斷符合率高于PCT； 2、sTREM-1聯(lián)合檢測PCT能提高CAP和HAP診斷的敏感性、特異性和診斷符合率； 3.CAP、 HAP血清中的sTREM-1、PCT和CRP的水平無明顯差異。
[Abstract]:Objective: to detect the levels of soluble myeloid cell trigger receptor-1 (sTREM-1) and procalcitonin (PCT), C-reactive protein (CRP) in peripheral blood of patients with pulmonary infection. To observe the diagnostic significance of sTREM-1 in pulmonary infection and whether there are differences between CAP and HAP, and to explore its clinical application value. Methods: the levels of sTREM-1,PCT,CRP in peripheral blood of the test group (30 patients with community-acquired pneumonia, 18 patients with hospital acquired pneumonia) and the control group (14 patients with diffuse pulmonary disease) were detected by ELISA method. The sensitivity, specificity and diagnostic coincidence rate were calculated. Results: (1) the serum sTREM-1 of CAP group (99.71 鹵111.17) pg/ml,PCT (10.26 鹵22.02) ug/ml was significantly higher than that of control group (P < 0. 05). (2) the serum sTREM-1 of HAP group (117.40 鹵134.73) pg/ml,PCT (8.67 鹵9.11) ug/ml was significantly higher than that of control group (P < 0. 05). (3) there was no significant difference in serum sTREM-1,PCT,CRP between CAP group and HAP group (P > 0. 05). (4) according to the ROC curve, the optimal threshold of sTREM-1 was 38.13 PG / ml. The diagnostic sensitivity and specificity of CAP were 0.900 and 0.786, respectively. The diagnostic coincidence rate was 0.864, which was higher than that of the same group (CRP (P < 0.05). The diagnostic sensitivity and diagnostic coincidence rate were higher than that of PCT (P < 0. 05); HAP in the same group (0. 889, specificity 0. 786, the diagnostic coincidence rate was 0. 844, higher than that in the same group CRP (P < 0. 05). Its diagnostic sensitivity and diagnostic coincidence rate were higher than those of the same group (PCT (P < 0. 05), the specificity of sTREM-1 was 0. 786, there was no significant difference between sTREM-1 and PCT. (5) the sensitivity, specificity and diagnostic coincidence rate of sTREM-1 PCT in CAP group and HAP group were higher than those in sTREM-1 alone (P < 0. 05). Conclusion: 1 the level of sTREM-1,PCT,CRP in serum of CAP and HAP is significantly increased, the sensitivity, specificity and diagnostic coincidence rate of sTREM-1 and PCT are higher than that of CRP;sTREM-1 and the diagnostic coincidence rate is higher than that of PCT;. (2) combined detection of PCT with sTREM-1 could improve the sensitivity, specificity and diagnostic coincidence rate of CAP and HAP, but there was no significant difference in the levels of sTREM-1,PCT and CRP between HAP and HAP.
【學位授予單位】：南昌大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R563

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