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目的 探讨急性呼吸窘迫综合征(ARDS)患者可溶性髓系细胞触发受体-1(sTREM-1)水平的变化规律及其与呼吸衰竭的相关性，并评估sTREM-1在ARDS早期诊断中的价值。方法 回顾性分析2022年1月至2024年12月本院ICU收治的80例ARDS患者的临床资料。收集患者的基本人口学资料、病史信息、临床表现及评分、实验室检查结果等基线资料。采用酶联免疫吸附试验(ELISA)检测患者在入院时、ARDS诊断后的第3天、第7天及出院时的sTREM-1水平。ARDS患者的临床病情变化通过急性生理学及慢性健康状况评估II评分(APACHE II)和序贯器官衰竭评估评分(SOFA)进行评估。通过动脉血氧分压/吸入氧气浓度(PaO2/FiO2)评估患者肺功能。结果 ARDS患者入院时sTREM-1水平为(280.12±55.34)pg/mL,入院后第3天和第7天分别升高至(530.41±122.12)pg/mL和(675.98±138.45)pg/mL,与入院时相比差异具有统计学意义(P<0.05)。出院时sTREM-1水平降至(310.79±78.47)pg/mL,但仍高于入院时的水平(P<0.05)。sTREM-1水平与PaO2/FiO2比值之间呈负相关关系(r=-0.722,P<0.05)。ROC曲线分析显示，sTREM-1水平超过250 pg/mL时，提示患者可能存在较严重的呼吸衰竭，AUC值为0.823,且sTREM-1在ARDS早期诊断中的价值优于APACHE II、SOFA和PaO2/FiO2。结论 sTREM-1水平在ARDS患者中显著升高，且与呼吸衰竭密切相关，具有较高的诊断价值。
Abstract：Objective To investigate the changes in soluble triggering receptor expressed on myeloid cells-1(sTREM-1) levels and its correlation with respiratory failure in patients with acute respiratory distress syndrome(ARDS), and to evaluate the value of sTREM-1 in the early diagnosis of ARDS. Methods A retrospective analysis was conducted on 80 ARDS patients admitted to the ICU of the hospital from January 2022 to December 2024. Baseline data including demographic characteristics, medical history, clinical manifestations and scores and laboratory results were collected. Plasma sTREM-1 levels were measured by enzyme-linked immunosorbent assay(ELISA) at admission, on the 3rd and 7th days after ARDS diagnosis, and at discharge. The clinical condition of ARDS patients was assessed using the Acute Physiology and Chronic Health Evaluation II(APACHE II) score and the Sequential Organ Failure Assessment(SOFA) score. Pulmonary function was evaluated by the ratio of arterial oxygen partial pressure to fractional inspired oxygen(PaO2/FiO2). Results The plasma sTREM-1 level in ARDS patients was(280.12±55.34) pg/mL at admission, and significantly increased to(530.41±122.12) pg/mL and(675.98±138.45) pg/mL on the 3rd and 7th days, respectively(P<0.05). At discharge, the sTREM-1 level decreased to(310.79±78.47) pg/mL, but remained higher than the baseline level(P<0.05). A significant negative correlation was observed between sTREM-1 level and PaO2/FiO2 ratio(r=-0.722, P<0.05). ROC curve analysis showed that when the sTREM-1 level exceeded 250 pg/mL, it suggested the presence of severe respiratory failure, with an AUC of 0.823. Furthermore, sTREM-1 demonstrated superior performance in the early diagnosis of ARDS compared to APACHE II, SOFA and PaO2/FiO2. Conclusion The level of sTREM-1 is significantly elevated in ARDS patients, closely associated with respiratory failure, and demonstrates high diagnostic value.
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基本信息:
中图分类号:R563.8
引用信息:
[1]杨玉梅,马海燕,陈晓燕,等.ARDS患者sTREM-1水平与呼吸衰竭的相关性及其在早期诊断中的应用[J].新疆医科大学学报,2025,48(11):1540-1545+1550.
基金信息:
首都卫生发展科研专项项目(QN2022-06)
2025-11-15
2025-11-15