可溶性sTREM-1作为呼吸机相关肺炎死亡率的预后生物标志物:一项前性观察性研究
Aishwarya Revanesh Aladakatti1, Biligere Siddaiah Jayaraj1, Chaya Krishnarao Sindaghatta1
1Department of Respiratory Medicine, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India.
Respiratory medicine
|October 29, 2025
概括
在骨髓细胞-1 (sTREM-1) 上表达的溶性触发受体显示出强烈的预后价值,用于呼吸机相关性肺炎 (VAP) 的结果. 在ICU患者中升高的sTREM-1水平预测死亡率,与临床评分相结合,改善风险分层.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 生物标志物研究 生物标志物研究
背景情况:
- 呼吸机相关肺炎 (VAP) 是ICU发病率和死亡率的重要原因.
- 在骨髓细胞-1 (sTREM-1) 上表达的溶性触发受体是一种具有评估感染严重程度潜力的炎症标记物.
- 在VAP中sTREM-1的预后效用需要进一步调查.
研究的目的:
- 评估VAP患者血清sTREM-1水平的预后值.
- 为了比较sTREM-1的预后准确性与已建立的临床严重性得分.
- 评估sTREM-1的附加值与VAP预后的临床评分相结合.
主要方法:
- 80名成人VAP患者 (40名幸存者,40名非幸存者) 在第三级护理ICU的前性观察研究.
- 在VAP诊断后24小时内通过ELISA测量血清sTREM-1水平.
- 分析包括ROC曲线,Cox回归和Kaplan-Meier生存分析,将sTREM-1与临床和炎症标志物相关联.
主要成果:
- 没有幸存者表现出明显高于幸存者的sTREM-1水平 (17.3vs7.2ppg/mL).
- sTREM-1与CRP,D-二次体和APACHE II正相关,与PaO2/FiO2和白蛋白负相关.
- sTREM-1显示出强大的预后准确性 (AUC 0.800),与APACHE II (AUC 0.825) 相比;联合使用改善了AUC至0.945.
结论:
- 血清sTREM-1是VAP的有价值的早期预后生物标志物.
- sTREM-1提供了超出已建立的临床评分系统的附加预后价值.
- 将sTREM-1与临床评分相结合,可以提高风险分层,并指导ICU管理决策.
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