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目的:探讨血浆可溶性髓系细胞触发受体1(s TREM-1)、降钙素原(PCT)、C反应蛋白(CRP)在脓毒症患儿诊断中的临床价值。方法:选取本院收治的70例脓毒症患儿作为脓毒症组、30例健康儿童作为健康组,检测脓毒症组患儿入院时的s TREM-1、PCT、CRP等指标的水平并与健康组进行比较,计算s TREM-1、PCT、CRP等鉴别诊断脓毒症患儿的诊断学指标。结果:脓毒症患儿的血浆s TREM-1、PCT、CRP、WBC测定值均显著高于健康组儿童且差异均具有统计学意义(P<0.05);普通脓毒症患儿的血浆s TREM-1、PCT、CRP、WBC及APACHEⅡ评分均显著低于严重脓毒症患儿且差异均具有统计学意义(P<0.05);脓毒症患儿的s TREM-1、PCT、CRP、WBC与APACHEⅡ评分均呈显著的正相关关系(P<0.05);s TREM-1诊断脓毒症患儿的临界值为97.05 pg·ml-1、PCT为2.29 pg·ml-1、CRP为84.47 pg·ml-1,s TREM-1诊断脓毒症患儿的灵敏度、特异度、AUC值高于PCT、CRP。结论:早期检测s TREM-1水平有利于脓毒症患儿的诊断,为临床治疗提供参考价值。
Objective: To investigate the clinical value of plasma soluble myeloid cell trigger receptor 1 (s TREM-1), procalcitonin (PCT) and C-reactive protein (CRP) in the diagnosis of sepsis in children. Methods: Seventy sepsis patients in our hospital were selected as sepsis group and 30 healthy children as healthy group. The levels of s-TREM-1, PCT and CRP in sepsis group were detected at hospital admission And compared with the healthy group to calculate the diagnostic indicators of s TREM-1, PCT, CRP differential diagnosis of sepsis in children. Results: The plasma levels of s-TREM-1, PCT, CRP and WBC in children with sepsis were significantly higher than those in healthy children (P <0.05). Plasma s The levels of TREM-1, PCT, CRP, WBC and APACHEⅡ in children with sepsis were significantly lower than those in children with severe sepsis (P <0.05) There was a significant positive correlation between WBC and APACHEⅡscore (P <0.05). The cutoff value of TREM-1 in sepsis children was 97.05 pg · ml-1, PCT was 2.29 pg · ml-1 and CRP was 84.47 pg · ml-1, s TREM-1 diagnosis of sepsis in children with sensitivity, specificity, AUC value higher than the PCT, CRP. Conclusion: Early detection of s-TREM-1 levels is beneficial to the diagnosis of sepsis in children, providing reference value for clinical treatment.