可溶性髓样细胞受体-1诊断小儿化脓性关节炎的价值
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摘要
目的探讨可溶性髓样细胞受体-1(s TREM-1)对小儿化脓性关节炎的临床诊断价值。方法选取2015年6月—2016年8月收治的41例化脓性关节炎患儿作为C组,同时选取同期于接受治疗的全身炎症反应综合征(SIRS)患者40例、进行体检的健康者40例分别作为B组、A组,三组均采用ELI法(酶联免疫测定法)在同一条件下测定血清s TREM-1、降钙素原(PCT)、C-反应蛋白(CRP)表达水平并对比。结果 (1) C组、B组患者s TREM-1、CRP、PCT表达水平明显高于A组,结果具统计学差异(P <0. 05)。与B组相比,C组s TREM-1、CRP、PCT表达水平明显更高,组间数据对比差异显著(P <0. 05)。(2)s TREM-1检测敏感度、特异度分别为86. 84%、100. 0%; CRP检测敏感度、特异度分别为83. 78%、75. 00%; PCT检测敏感度、特异度分别为86. 49%、75. 00%,三种检测指标诊断敏感性对比无统计学差异(P> 0. 05); s TREM-1诊断特异度明显高于CRP、PCT诊断,结果具有统计学差异(P <0. 05)。(3) s TREM-1曲线下面积为0. 912,明显大于PCT(0. 884)、CRP(0. 854),结果具有统计学差异(P <0. 05)。结论血清s TREM-1用于小儿化脓性关节炎诊断价值高,可在临床推广。
Objective To explore the clinical value of soluble triggering receptor expressed on myeloid cell-1(s TREM-1) in diagnosis of septic arthritis in children. Methods Overall 41 cases of children patients with septic arthritis in our hospital from June 2015 to August 2016 were selected as group C,and 40 patients with systemic inflammatory response syndrome( SIRS) who were treated in our hospital at the same time,along with 40 healthy subjects,were selected as group B and group A respectively. The expression levels of serum s TREM-1,procalcitonin( PCT) and C-reactive protein(CRP) were determined and compared by enzyme linked immunosorbent assays(ELI assays) at the same condition. Results The expression levels of s TREM-1,CRP and PCT in group C were significantly higher than that in group A,P < 0. 05).Compared with group B,the expression levels of s TREM-1,CRP and PCT in group C were significantly higher than that in group B( P < 0. 05). The sensitivity and specificity of s TREM-1 were 86. 84% and 100. 00% respectively. The sensitivity and specificity of CRP were 83. 78% and 75. 00%,and those of PCT were 86. 49% and 75. 00% respectively. There were no significant differences in the diagnostic sensitivity between the three indexes( P > 0. 05). The diagnostic specificity of s TREM-1 was significantly higher than those of CRP and PCT( P < 0. 05). The area under the curve of s TREM-1 was 0. 912,which was significantly larger than that of PCT(0. 884) and CRP(0. 854),and the difference was significant( P <0. 05). Conclusion Serum s TREM-1 is valuable in the diagnosis of septic arthritis in children and it can be applied in clinic application.
Objective To explore the clinical value of soluble triggering receptor expressed on myeloid cell-1(s TREM-1) in diagnosis of septic arthritis in children. Methods Overall 41 cases of children patients with septic arthritis in our hospital from June 2015 to August 2016 were selected as group C,and 40 patients with systemic inflammatory response syndrome( SIRS) who were treated in our hospital at the same time,along with 40 healthy subjects,were selected as group B and group A respectively. The expression levels of serum s TREM-1,procalcitonin( PCT) and C-reactive protein(CRP) were determined and compared by enzyme linked immunosorbent assays(ELI assays) at the same condition. Results The expression levels of s TREM-1,CRP and PCT in group C were significantly higher than that in group A,P < 0. 05).Compared with group B,the expression levels of s TREM-1,CRP and PCT in group C were significantly higher than that in group B( P < 0. 05). The sensitivity and specificity of s TREM-1 were 86. 84% and 100. 00% respectively. The sensitivity and specificity of CRP were 83. 78% and 75. 00%,and those of PCT were 86. 49% and 75. 00% respectively. There were no significant differences in the diagnostic sensitivity between the three indexes( P > 0. 05). The diagnostic specificity of s TREM-1 was significantly higher than those of CRP and PCT( P < 0. 05). The area under the curve of s TREM-1 was 0. 912,which was significantly larger than that of PCT(0. 884) and CRP(0. 854),and the difference was significant( P <0. 05). Conclusion Serum s TREM-1 is valuable in the diagnosis of septic arthritis in children and it can be applied in clinic application.
引文
[1]夏冰,刘福云,郭永成,等.婴幼儿下肢多关节化脓性感染临床分析[J].中华实用诊断与治疗杂志,2014,28(8):794-795.
[2]杨瑞.非结核革兰氏阳性杆菌人工关节感染的临床研究[D].北京:中国人民解放军军医进修学院,2013.
[3]林吉霞,王佳怡,李伟,等.髓样细胞表达激发受体1在骨与关节疾病中的研究进展[J].医学综述,2017,23(10):1908-1913.
[4]郁志伟,钱俊,顾晓虹.可溶性髓系细胞触发受体-1在婴幼儿社区获得性肺炎中的作用[J].中华实用儿科临床杂志,2015,30(22):1744-1745.
[5]周梦瑶,于钧.退行性骨关节炎的研究现况[J].中华地方病学杂志,2015,34(7):534-538.
[6]王利军.加味阳和汤辅助关节镜治疗膝骨性关节炎的临床分析[J].中国当代医药,2013,20(1):119-120.
[7]张吉红,王晓娟,吴五洲,等.关节镜在膝关节化脓性关节炎诊治中的临床应用[J].华西医学,2016,22(4):675-678.
[8]柯俊,林鹏,程慧,等.关节镜下微创有限清理治疗膝关节骨性关节炎的效果观察[J].中国当代医药,2015,22(34):115-117.
[9]王宇,梅继文,穆尚强,等.新型医用局部灌洗泵治疗膝关节化脓性关节炎41例疗效分析[J].中国全科医学,2016,19(26):3223-3226.
[10]李瞿,张小倩,刘旭,等.ABCGl基因多态性与中国汉族人群缺血性脑卒中的相关性研究[J].中国临床神经科学,2016,24(1):365-370.
[11]李健球,熊旭明.可溶性髓样细胞触发受体1在感染性疾病中的研究应用进展[J].医学综述,2014,20(16):2895-2898.
[12]罗运山,刘易林,邓霞梅,等.PCT、s TREM-1结合APACHEⅡ评分对脓毒症诊断和预后的价值[J].实用医学杂志,2017,33(4):586-590.
[13]高晓岚,艾中平,湛晓勤,等.s TREM-1在铜绿假单胞菌感染和定植的表达及意义[J].重庆医学,2013,42(19):2246-2248.
[14]冬兰,尹秋生.可溶性髓样细胞触发受体-1在感染性疾病诊断中的作用[J].中华保健医学杂志,2015,17(1):72-73.
[15]陈宜阳.猪戊型肝炎病毒抗体阻断ELISA检测方法的建立与应用[D].杨凌:西北农林科技大学,2016.
[16]徐志康,陈望,刘和录,等.利用ROC曲线分析s TREM-1、PCT和CRP对多发伤早期感染的诊断价值[J].中国实验诊断学,2011,15(11):1885-1887.
[17]霍江波,于淑霞.血清Hs-CRP与PCT联合检测对肝硬化腹水合并自发性细菌性腹膜炎的诊断价值[J].胃肠病学和肝病学杂志,2017,26(8):930-933.
[2]杨瑞.非结核革兰氏阳性杆菌人工关节感染的临床研究[D].北京:中国人民解放军军医进修学院,2013.
[3]林吉霞,王佳怡,李伟,等.髓样细胞表达激发受体1在骨与关节疾病中的研究进展[J].医学综述,2017,23(10):1908-1913.
[4]郁志伟,钱俊,顾晓虹.可溶性髓系细胞触发受体-1在婴幼儿社区获得性肺炎中的作用[J].中华实用儿科临床杂志,2015,30(22):1744-1745.
[5]周梦瑶,于钧.退行性骨关节炎的研究现况[J].中华地方病学杂志,2015,34(7):534-538.
[6]王利军.加味阳和汤辅助关节镜治疗膝骨性关节炎的临床分析[J].中国当代医药,2013,20(1):119-120.
[7]张吉红,王晓娟,吴五洲,等.关节镜在膝关节化脓性关节炎诊治中的临床应用[J].华西医学,2016,22(4):675-678.
[8]柯俊,林鹏,程慧,等.关节镜下微创有限清理治疗膝关节骨性关节炎的效果观察[J].中国当代医药,2015,22(34):115-117.
[9]王宇,梅继文,穆尚强,等.新型医用局部灌洗泵治疗膝关节化脓性关节炎41例疗效分析[J].中国全科医学,2016,19(26):3223-3226.
[10]李瞿,张小倩,刘旭,等.ABCGl基因多态性与中国汉族人群缺血性脑卒中的相关性研究[J].中国临床神经科学,2016,24(1):365-370.
[11]李健球,熊旭明.可溶性髓样细胞触发受体1在感染性疾病中的研究应用进展[J].医学综述,2014,20(16):2895-2898.
[12]罗运山,刘易林,邓霞梅,等.PCT、s TREM-1结合APACHEⅡ评分对脓毒症诊断和预后的价值[J].实用医学杂志,2017,33(4):586-590.
[13]高晓岚,艾中平,湛晓勤,等.s TREM-1在铜绿假单胞菌感染和定植的表达及意义[J].重庆医学,2013,42(19):2246-2248.
[14]冬兰,尹秋生.可溶性髓样细胞触发受体-1在感染性疾病诊断中的作用[J].中华保健医学杂志,2015,17(1):72-73.
[15]陈宜阳.猪戊型肝炎病毒抗体阻断ELISA检测方法的建立与应用[D].杨凌:西北农林科技大学,2016.
[16]徐志康,陈望,刘和录,等.利用ROC曲线分析s TREM-1、PCT和CRP对多发伤早期感染的诊断价值[J].中国实验诊断学,2011,15(11):1885-1887.
[17]霍江波,于淑霞.血清Hs-CRP与PCT联合检测对肝硬化腹水合并自发性细菌性腹膜炎的诊断价值[J].胃肠病学和肝病学杂志,2017,26(8):930-933.