可溶性髓样细胞触发受体-1在化脓性关节炎诊断及疗效评价分析
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摘要
目的分析可溶性髓样细胞触发受体-1(sTREM-1)在化脓性关节炎诊断及疗效评价中的价值,为感染性疾病诊断和治疗工作提供研究依据。方法选取2015年2月-2017年2月医院收治的50例化脓性关节炎患者作为化脓性关节炎组,选取同期35例单纯骨关节炎患者作为骨关节炎组,选取同期30名健康体检者作为对照组。检测研究对象血液中sTREM-1、C-反应蛋白(CRP)、红细胞沉降率(ESR)水平,对化脓性关节炎组和骨关节炎组患者关节液中sTREM-1水平进行检测和比较;分析患者sTREM-1、CRP及ESR水平在化脓性关节炎诊断中的价值,观察化脓性关节炎组患者的临床疗效。结果三组研究对象血液sTREM-1水平、血液CRP水平、ESR水平比较差异有统计学意义(P<0.05),其中化脓性关节炎组患者指标水平最高;化脓性关节炎组患者关节液sTREM-1水平为(82.05±62.97)ng/L高于骨关节炎组的(43.36±7.48)ng/L,两组比较差异有统计学意义(t=9.628,P<0.001);关节液sTREM-1、血液sTREM-1、CRP水平诊断化脓性关节炎患者的受试者工作特征曲线下面积(AUC)分别为0.913、0.841、0.785;关节液sTREM-1水平较低的化脓性关节炎患者的疗效分布优于关节液sTREM-1水平较高的患者(Z=2.260,P=0.024)。结论化脓性关节炎表现为关节液和血液sTREM-1表达水平的上调,可作为诊断化脓性关节炎的辅助指导,术前检测关节液sTREM-1水平也有助于预测手术治疗的效果。
OBJECTIVE To analyze the value of soluble triggering receptor expressed on myeloid cells-1(sTREM-1)in diagnosis of suppurative arthritis and evaluation of curative effect so as to provide guidance for clinical diagnosis and treatment of infectious diseases.METHODS Totally 50 patients with suppurative arthritis who were treated in the hospital from Feb 2015 to Feb 2017 were assigned as the suppurative arthritis group,meanwhile,35 patients with single osteoarthritis were chosen as the osteoarthritis group,and 30 healthy people who received physical examination were set as the control group.The levels of serum sTREM-1,C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR)of the study objects were detected,the level of synovial fluid sTREM-1 was detected and compared between the suppurative arthritis group and the osteoarthritis group.The values of sTREM-1,CRP and ESR in diagnosis of suppurative arthritis were analyzed,and the clinical curative effects of the patients with suppurative arthritic were observed.RESULTS There were significant differences in the levels of plasma sTREM-1,CRP and ESR among the three groups of study objects(P<0.05),the levels of the above indexes were the highest in the suppurative arthritis group.The synovial fluid sTREM-1 level of the suppurative arthritis group was(82.05±62.97)ng/L,significantly higher than(43.36±7.48)ng/L of the osteoarthritis group(t=9.628,P<0.001).The areas under receiver operating characteristic(ROC)curve of the synovial fluid sTREM-1,plasma sTREM-1 and CRP were 0.913,0.841 and 0.785,respectively.The curative effect of the suppurative arthritis patients with low level of synovial fluid sTREM-1 was significantly better than that of the patients with high level of synovial fluid sTREM-1(Z=2.260,P=0.024).CONCLUSION The levels of expression of synovial fluid and plasma sTREM-1 are upregulated in the patients with suppurative arthritis,which can be used for the auxiliary diagnosis of the suppurative arthritis,and the preoperative detection of the synovial fluid sTREM-1 may facilitate the prediction of the curative effect.
OBJECTIVE To analyze the value of soluble triggering receptor expressed on myeloid cells-1(sTREM-1)in diagnosis of suppurative arthritis and evaluation of curative effect so as to provide guidance for clinical diagnosis and treatment of infectious diseases.METHODS Totally 50 patients with suppurative arthritis who were treated in the hospital from Feb 2015 to Feb 2017 were assigned as the suppurative arthritis group,meanwhile,35 patients with single osteoarthritis were chosen as the osteoarthritis group,and 30 healthy people who received physical examination were set as the control group.The levels of serum sTREM-1,C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR)of the study objects were detected,the level of synovial fluid sTREM-1 was detected and compared between the suppurative arthritis group and the osteoarthritis group.The values of sTREM-1,CRP and ESR in diagnosis of suppurative arthritis were analyzed,and the clinical curative effects of the patients with suppurative arthritic were observed.RESULTS There were significant differences in the levels of plasma sTREM-1,CRP and ESR among the three groups of study objects(P<0.05),the levels of the above indexes were the highest in the suppurative arthritis group.The synovial fluid sTREM-1 level of the suppurative arthritis group was(82.05±62.97)ng/L,significantly higher than(43.36±7.48)ng/L of the osteoarthritis group(t=9.628,P<0.001).The areas under receiver operating characteristic(ROC)curve of the synovial fluid sTREM-1,plasma sTREM-1 and CRP were 0.913,0.841 and 0.785,respectively.The curative effect of the suppurative arthritis patients with low level of synovial fluid sTREM-1 was significantly better than that of the patients with high level of synovial fluid sTREM-1(Z=2.260,P=0.024).CONCLUSION The levels of expression of synovial fluid and plasma sTREM-1 are upregulated in the patients with suppurative arthritis,which can be used for the auxiliary diagnosis of the suppurative arthritis,and the preoperative detection of the synovial fluid sTREM-1 may facilitate the prediction of the curative effect.
引文
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[11]Wang F,Wang Y,Wang R,et al.Predictive value of maternal serum NF-κB p65and sTREM-1for subclinical chorioamnionitis in premature rupture of membranes[J].Am J Reprod Immunol,2016,76(3):217-223.
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[13]陈化磊,卓小岸,肖劲逐,等.尿源性感染导致脓毒血症患者血清sTREM-1的检测评价[J].中华医院感染学杂志,2017,27(16):3669-3672.
[14]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,2016,31(4):675-678.
[2]Dierig A,Ritz N,Tacke U,et al.Group A streptococcal suppurative arthritis and osteomyelitis of the shoulder with brachial plexus palsy in a newborn[J].Pediatr Infect Dis J,2016,35(10):1151-1153.
[3]陈旭狮,宋祖坤,林振,等.糖皮质激素辅助抗生素治疗儿童化脓性关节炎疗效的Meta分析[J].中国骨与关节杂志,2017,16(1):57-62.
[4]中华医学会风湿病学分会.骨关节炎诊断及治疗指南[J].中华风湿病学杂志,2010,14(6):416-419.
[5]武志伟.关节镜手术治疗早中期膝关节化脓性关节炎效果观察[J].社区医学杂志,2017,15(15):36-37.
[6]王刚,王炎焱,朱剑,等.感染性骶髂关节炎21例临床分析[J].中华内科杂志,2015,54(5):420-425.
[7]万楠,王璐,孟冬娅,等.炎症标志物在感染性和痛风性关节炎中鉴别诊断的应用价值[J].现代检验医学杂志,2015,23(3):142-144.
[8]金涛,李璐,金卉,等.金黄色葡萄球菌感染致化脓性关节炎的临床研究[J].中华医院感染学杂志,2015,25(19):4418-4420.
[9]危立军,罗军,易观俊,等.血清降钙素原及血沉与C-反应蛋白联合检测诊断化脓性关节炎临床价值[J].中华医院感染学杂志.2015,25(20):4664-4666.
[10]陆丽丽,刘丹.髓样细胞触发受体样转录因子-1的研究进展[J].中风与神经疾病杂志,2016,33(10):952-954.
[11]Wang F,Wang Y,Wang R,et al.Predictive value of maternal serum NF-κB p65and sTREM-1for subclinical chorioamnionitis in premature rupture of membranes[J].Am J Reprod Immunol,2016,76(3):217-223.
[12]张毅,沈锋.内镜介入治疗急性化脓性胆管炎对HMGBl、sTREM-1和hs-CRP的影响[J].现代中西医结合杂志,2016,25(4):357-359,364.
[13]陈化磊,卓小岸,肖劲逐,等.尿源性感染导致脓毒血症患者血清sTREM-1的检测评价[J].中华医院感染学杂志,2017,27(16):3669-3672.
[14]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,2016,31(4):675-678.