血清sTREM-1、CD64、sCD163与脓毒症患者病情严重程度及预后的相关性

王勇　孙琳

【摘要】 目的：探討血清可溶性髓样细胞表达触发受体-1（sTREM-1）、中性粒细胞CD64、可溶性血红蛋白清道夫受体（sCD163）与脓毒症患者病情严重程度及预后的相关性。方法：选取笔者所在医院2018年1月-2019年12月收治的100例脓毒症患者，根据病情严重程度分为轻度组34例，严重组36例，休克组30例，并根据不同转归分为存活组和死亡组。统计不同病情程度及转归情况患者血清sTREM-1、CD64、sCD163水平，分析其与病情严重程度及预后的相关性。结果：休克组血清sTREM-1、CD64、sCD163水平均高于严重组及轻度组，且严重组血清sTREM-1、CD64、sCD163水平均高于轻度组，差异均有统计学意义（P<0.05）;存活组血清sTREM-1、CD64、sCD163水平均低于死亡组，差异均有统计学意义（P<0.05）;经Pearson相关性检验显示，血清sTREM-1、CD64、sCD163与脓毒症患者病情严重程度呈正相关（P<0.05），与预后呈负相关（P<0.05）。结论：血清sTREM-1、CD64、sCD163与脓毒症患者病情严重程度及预后关系密切，均可作为预测脓毒症患者病情严重程度及预后的参考指标。

【关键词】 脓毒症 sTREM-1 CD64 sCD163 病情严重程度 预后 相关性

doi：10.14033/j.cnki.cfmr.2020.18.057 文献标识码 B 文章编号 1674-6805（2020）18-0-03

Correlation of Serum sTREM-1， CD64 and sCD163 with Severity and Prognosis of Sepsis/WANG Yong， SUN Lin. //Chinese and Foreign Medical Research， 2020， 18（18）： -135

[Abstract] Objective： To investigate the correlation between serum soluble myeloid cell expression trigger receptor-1（sTREM-1）， neutrophil CD64， soluble hemoglobin scavenger receptor （sCD163） and severity and prognosis of patients with sepsis. Method： A total of 100 sepsis patients admitted to the authors hospital from January 2018 to December 2019 were selected and divided into the mild group （34 cases）， the severe group （36 cases） and the shock group （30 cases） according to the severity of the disease， and a survival group and a death group according to different outcomes， and they were divided into the survival group and the death group according to different outcomes. The serum streM-1， CD64 and sCD163 levels of patients with different disease degrees and outcomes were calculated， and the correlation between sTREM-1， CD64 and sCD163 levels and disease severity and prognosis were analyzed. Result： The serum streM-1， CD64 and sCD163 levels in the shock group were all higher than those in the severe group and the mild group， and serum sTREM-1， CD64 and sCD163 levels in the severe group were all higher than those in the mild group， the differences were statistically significant （P<0.05）. The serum sTREM-1， CD64 and sCD163 levels in the survival group were all lower than those in the death group， the differences were statistically significant （P<0.05）. Pearson correlation test showed that serum StreM-1， CD64， sCD163 were positively correlated with severity of sepsis patients （P<0.05）， and negatively correlated with prognosis （P<0.05）. Conclusion： Serum StreM-1， CD64 and sCD163 are closely related to the severity and prognosis of patients with sepsis， and can be used as reference indicators to predict the severity and prognosis of patients with sepsis.

[Key words] Sepsis sTREM-1 CD64 sCD163 Severity of illness Prognosis Correlation

First-authors address： Qichun County Peoples Hospital， Qichun 435300， China

脓毒症是临床常见重症感染性疾病，其病情凶险、进展迅速，如不及时诊治，预后极差，病死率极高，故早期确诊并施以有效的治疗手段对改善患者预后，降低病死率具有重要意义[1]。可溶性髓系细胞触发受体-1（sTREM-1）是一种免疫球蛋白，也是一种促炎因子，研究发现，在感染性疾病中髓系细胞触发受体-1（TREM-1）的表达增高，且伴有sTREM-1的释放，故认为其与感染严重程度密切相关[2]。中性粒细胞表面CD64是IgG的Fc段受体，在受到刺激因子或干扰素-1因子刺激时，可在中性粒细胞表面大量表达，临床将其作为区分感染和诊断败血症的有效指标[3]。可溶性血红蛋白清道夫受体（sCD163）是巨噬细胞细胞膜上的跨膜分子，具有促进炎性介质释放，加剧炎症反应的作用，临床将其作为判断社区获得性肺炎、败血症、脓毒症的早期敏感指标[4]。……