sTREM―1IL―17PCT及PA联合检测在重症肺炎中诊断价值.docVIP

sTREM―1IL―17PCT及PA联合检测在重症肺炎中诊断价值 　　[摘要] 目的 探讨可溶性髓系细胞表达的触发受体-1（sTREM-1）、白介素17（IL-17）、降钙素原（PCT）、前白蛋白（PA）?合检测在重症肺炎（SP）中的诊断价值。 方法 采用双抗体夹心酶联免疫法（ELISA）、免疫比浊法检测120例SP患者（SP组）、50例健康体检者（对照组）血清中sTREM-1、IL-17、PCT及PA水平，比较不同预后患者上述生物标志物水平的变化，分析其与SP的相关性。测定并比较不同检测方法的敏感性、特异性、准确率、阳性预测值、阴性预测值等指标。 结果 SP组sTREM-1、IL-17、PCT水平明显高于对照组，而PA水平则明显降低（P0.05），死亡当天水平明显升高（P0.05）；联合检测的敏感性、特异性、准确率、阴性预测值分别为84.2%、94.0%、87.1%、71.2%，明显高于sTREM-1、IL-17、PCT及PA任一单项检测的敏感性、特异性、准确率及阴性预测值（P0.05）。 结论 SP患者血清sTREM-1、IL-17、PCT水平明显升高，PA水平明显降低，与SP及其病情严重程度密切相关。联合检测可提高SP的早期诊断率并指导疗效评估。 　　[关键词] 重症肺炎；sTREM-1；IL-17；PCT；PA；诊断 　　[中图分类号] R563.1 [文献标识码] A [文章编号] 1673-9701（2018）03-0034-04 　　The value of sTREM-1， IL-17， PCT and PA combined detection in the diagnosis of severe pneumonia 　　ZHAO Jiwei JU Guowen BAI Limei 　　Department of Laboratory， Zhejiang Sian International Hospital， Jiaxing 314000， China 　　[Abstract] Objective To investigate the value of the combination detection of trigger receptor-1（sTREM-1）， interleukin-17（IL-17）， procalcitonin（PCT） and prealbumin（PA） which were expressed in soluble myeloid cells in the diagnosis of severe pneumonia. Methods The levels of serum sTREM-1， IL-17， PCT and PA in 120 patients with SP（SP group） and 50 healthy subjects（control group） were detected by double antibody sandwich enzyme-linked immunosorbent assay（ELISA） and immunoturbidimetry. The changes of these biomarkers in patients with different prognosis were compared， and their correlation with SP was analyzed. The sensitivity， specificity， accuracy， positive predictive value and negative predictive value of different detection methods were measured and compared. Results The levels of sTREM-1， IL-17 and PCT in SP group were significantly higher than those in the control group， while the level of PA was significantly lower than that of the control group（P0.05）， and the level of sTREM-1 was significantly higher on the day of death（P 　　[Key words] Severe pneumonia； sTREM-1； IL-17； PCT； PA； Diagnosis 　　重症肺炎（SP）是呼吸系统的急危重病，病情发展迅速