[Clinical study on plasma soluble triggering receptor expressed on myeloid cells-1 in patients with sepsis]

To observe the dynamic changes in plasma soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), and to approach the effect on predicting outcome of the patient with sepsis combined with sepsis-related organ failure assessment (SOFA) score.

Using prospective, randomly control study design, 32 patients admitted to intensive care unit (ICU) of the Second Hospital of Tianjin Medical University suffering from sepsis between May 2009 and June 2010 were collected.They were divided into survival group (n=21) and non-survival group (n=11) according to 28-day survival. Platelet count (PLT) was determined on the 1st, 3rd, 7th day and SOFA score was assessed. Levels of sTREM-1 in plasma were measured by enzyme linked immunosorbant assay (ELISA). Twenty-five health volunteers served as controls.

The PLT was (248.88±48.62)×10(9)/L and the level of sTREM-1 was 25.7 (21.5, 53.3) ng/L in the control group. In non-survivors, the level of PLT (×10(9)/L) was significantly lower on 1st day with a tendency of degression (the level on 1st, 3rd, 7th day was 95.77±47.42, 91.92±35.78, 82.31±31.04, respectively), SOFA score decreased gradually (the score on 1st, 3rd, 7th day was 12.36±4.30, 10.90±5.32, 7.87±4.60, respectively). On the contrary, the level of sTREM-1 (ng/L) was significantly higher on 1st day with a tendency of elevation [the level on 1st, 3rd, 7th day was 360.5 (262.2, 434.5), 373.5 (263.1, 495.6), 496.6 (380.0, 571.8), respectively]. In survivors, PLT (×10(9)/L) began to decrease on the 3rd day, and then it increased (the level on 1st, 3rd, 7th day was 152.94±85.59, 136.18±75.30, 165.41±61.36, respectively), SOFA score lowered gradually (the score on 1st, 3rd, 7th day was 6.76±2.71, 4.29±2.31, 2.52±1.03, respectively), the peak level of sTREM-1 (ng/L) appeared on the 1st day, then it decreased gradually [the level on 1st, 3rd, 7th day was 204.1 (175.0, 269.6), 164.0 (145.9, 194.2), 81.5 (62.1, 109.0), respectively]. PLT was significantly lower, and SOFA score and sTREM-1 were significantly higher in non-survivors than those of survivors at different time points (P<0.05 or P<0.01). The level of sTREM-1 showed obvious negative correlation with PLT (r=-0.257, P=0.042), positive correlation with SOFA score (r=0.736, P=0.002).

The plasma sTREM-1 concentration was elevated at the early stage in patients with sepsis. Dynamic changes in sTREM-1 level combined with SOFA score may be helpful in predicting outcome of the patient with sepsis.