摘要目的 分析血浆可溶性髓样细胞触发受体1(sTREM-1)、可溶性血管内皮生长因子受体(sFLT-1)及急性生理学及慢性健康状况(APACHEⅡ)评分对重症肺炎患者预后评估价值.方法 选择我院2015年12月至2017年6月收治的48例重症肺炎患者,参照疾病转归情况分为死亡组(n=16)和生存组(n =32),同期选择50例普通肺炎患者,47例健康者作为对照组.比较各组血浆sTREM-1、sFLT-1及APACHEⅡ评分变化并分析之间的相关性和预后的联系.结果 重症肺炎组血浆sTREM-1、sFLT 1及APACHEⅡ评分均明显高于普通肺炎组且高于对照组,比较差异有统计学意义(P＜0.05).死亡组第1天血浆sTREM-1、sFLT-1及APACHEⅡ评分显著高于同期存活组,死亡组第7天血浆sTREM-1、sFLT-1及APACHEⅡ评分明显上升,存活组明显下降,比较差异有统计学意义(P＜0.05).血浆sTREM-1与sFLT-1、APACHEⅡ评分均呈正相关(r=0.761、0.612,P值均＜0.05);血浆sFLT-1与APACHEⅡ评分呈正相关(r=0.604,P＜0.05).经多因素logistic回归分析可见,血浆sTREM-1与sFLT-1、APACHEⅡ评分是影响患者死亡的独立性危险因素.结论 血浆sTREM-1、sFLT-1和APACHEⅡ评分能够提示重症肺炎患者的病情,动态观察其变化有利于预后的判断,指导临床治疗.

abstractsObjective To analyze the prognostic evaluation value of plasma soluble myeloid cells trigger receptor 1 (sTREM-1),soluble vascular endothelial growth factor receptor (sFLT 1) and acute physiology and chronic health conditions (APACHE Ⅱ) score score in patients with severe pneumonia.Methods Forty-eight cases of patients with severe pneumonia was from December 2015 to June 2017,according to the disease outcome.They were divided into death group (n =16) and survival group (n =32),50 patients with common pneumonia were selected in the same period,47 healthy subjects were used as control group.We compared plasma sTREM-1,sFLT 1 and APACHE Ⅱ score changes between each groups and analyzed the correlation between the link,and prognosis.Results Plasma sTREM-1,sFLT-1and APACHE Ⅱ score of plasma severe pneumonia group were significantly higher than ordinary pneumonia group and higher than the control group,which showed significant differences (P ＜ 0.05).Plasma sTREM-1,sFLT-1 and APACHE Ⅱ score of death group were significantly higher than the survival group same period,plasma of sTREM 1,sFLT-1 and APACHE Ⅱ score in death group were obviously rised,survival group obviously decreased,which showed significant differences (P ＜ 0.05).Plasma sTREM-1,sFLT-1,APACHE Ⅱ scores were positively correlated (r =0.761,0.612,both P ＜0.05);Plasma sFLT-1 with APACHE Ⅱ scores was positively correlated (r =0.604,P ＜0.05).The multi-factor logistic regression analysis showed the plasma and sTREM-1,sFLT-1,APACHE Ⅱ scores were rating risk factors which affected the independence of the patients died.Conclusions Plasma sTREM-1,sFLT-1 and APACHE Ⅱ score can show the condition of patients with severe pneumonia,dynamic observation of the changes is helpful for prognosis judgement,which can guide clinical treatment.