可溶性髓系细胞触发受体—1在骨科感染患者中的表达及其意义(1)
[摘要]目的 探讨骨科感染患者血清可溶性髓系细胞触发受体-1(sTREM-1)的浓度变化，为骨科感染的临床诊断提供一种新的客观指标。方法 从2015年4月～2016年3月本院患者中选取30例确诊骨科感染者作为感染组，30例健康成年人作为对照组。所有入选者均于清晨采集空腹静脉血，采用ELSIA法测定血清中的sTREM-1浓度，并对结果进行统计学分析。结果 感染组的sTREM-1平均浓度较对照组明显升高，差异有统计学意义(P<0.05)。感染组的阳性率为93.3%，显著高于对照组的10.0%，差异有统计学意义(P<0.05)。结论 血清sTREM-1浓度升高可为骨科感染提供一个新的客观指标，在排除其他感染病灶后，若其浓度较高，提示有感染灶存在，这为抗生素的合理应用提供了证据。
[关键词]可溶性髓系细胞触发受体-1；骨科感染；抗生素
[中图分类号] R681.2 [文献标识码] A [文章编号] 1674-4721(2016)07(c)-0023-03
[Abstrac]Objective To explore the serum concentration change of serum soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) from the orthopaedic infection patients and to find a new objective index for clinical diagnosis.Methods 30 patients with orthopaedic infection from April 2015 to March 2016 in our hospital were selected as the infection group，30 healthy people were selected as the control group.The fasting venous blood was collected in the early morning of all the cases.The serum concentration of sTREM-1 was determined by ELSIA method，and the results were statistically analyzed.Results The average concentration of sTREM-1 in the infection group was higher than that in the control group，with significant difference (P<0.05).The positive rate of infection group was 93.3%，which was higher than 10.0% in the control group，with significant difference (P<0.05).Conclusions sTREM-1 is a valuable predictor for the early diagnosis of blood stream orthopaedic infection.The rising of the serum concentration of sTREM-1 suggests the presence of infection，excluded other infections，which provides strong evidence to guide the reasonable use of antibiotics.
[Key words]Soluble triggering receptor expressed on myeloid cells-1；Orthopaedic infection；Antibiotics
骨科感染治疗周期长、费用高，因此早期诊断显得尤为重要。临床常用的传统炎症指标有白细胞计数、C反应蛋白(CRP)等，但因其受较多因素影响，不能客观反映体内的实际情况。可溶性髓系细胞触发受体-1(soluble triggering receptor expressed on myeloid cells-1，sTREM-1)是髓系细胞触发受体-1(TREM-1)溶于血液或体液内的亚型，是新发现的一种炎症指标，能放大炎症反应，通过对其检测，能更早地发现感染[1]。已进行的研究多集中在脓毒症、肺部感染、腹腔感染等疾病[2-4]，而关于骨科感染血清中sTREM-1表达的相关研究较少。本研究旨在探讨骨科感染与血清sTREM-1表达的相关性，为骨科感染的诊断寻找一种新的炎症指标。
1资料与方法
1.1一般资料
选取2015年4月～2016年3月本院骨科收治的60例患者作为研究对象，将其中的30例确诊细菌感染者作为感染组，包括男性16例，女性14例；年龄为18～56岁，平均(34.5±3.8)岁；创伤15例，自发感染5例。将30例行内固定物取出的健康者作为对照组，包括男性18例，女性12例；年龄为16～57岁，平均(32.2±2.5)岁。
1.2纳入与排除标准
1.2.1感染组纳入标准 ①确诊为骨科感染，感染的诊断标准参照《医院感染诊断标准》[5]，感染组患者细菌培养均为阳性；②排除其余部位存在感染灶；③可存在发热或无发热。
1.2.2对照组纳入标准 ①为骨科入院拟行取内固定物的患者；②排除其余部位感染灶存在；③体温正常，无发热。
1.2.3两组的排除标准 合并其他器官感染，如上呼吸道感染、泌尿系感染。 (郭永贤 宋世江 周献伟 房中卫 陈云浩 林雪林)
[关键词]可溶性髓系细胞触发受体-1；骨科感染；抗生素
[中图分类号] R681.2 [文献标识码] A [文章编号] 1674-4721(2016)07(c)-0023-03
[Abstrac]Objective To explore the serum concentration change of serum soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) from the orthopaedic infection patients and to find a new objective index for clinical diagnosis.Methods 30 patients with orthopaedic infection from April 2015 to March 2016 in our hospital were selected as the infection group，30 healthy people were selected as the control group.The fasting venous blood was collected in the early morning of all the cases.The serum concentration of sTREM-1 was determined by ELSIA method，and the results were statistically analyzed.Results The average concentration of sTREM-1 in the infection group was higher than that in the control group，with significant difference (P<0.05).The positive rate of infection group was 93.3%，which was higher than 10.0% in the control group，with significant difference (P<0.05).Conclusions sTREM-1 is a valuable predictor for the early diagnosis of blood stream orthopaedic infection.The rising of the serum concentration of sTREM-1 suggests the presence of infection，excluded other infections，which provides strong evidence to guide the reasonable use of antibiotics.
[Key words]Soluble triggering receptor expressed on myeloid cells-1；Orthopaedic infection；Antibiotics
骨科感染治疗周期长、费用高，因此早期诊断显得尤为重要。临床常用的传统炎症指标有白细胞计数、C反应蛋白(CRP)等，但因其受较多因素影响，不能客观反映体内的实际情况。可溶性髓系细胞触发受体-1(soluble triggering receptor expressed on myeloid cells-1，sTREM-1)是髓系细胞触发受体-1(TREM-1)溶于血液或体液内的亚型，是新发现的一种炎症指标，能放大炎症反应，通过对其检测，能更早地发现感染[1]。已进行的研究多集中在脓毒症、肺部感染、腹腔感染等疾病[2-4]，而关于骨科感染血清中sTREM-1表达的相关研究较少。本研究旨在探讨骨科感染与血清sTREM-1表达的相关性，为骨科感染的诊断寻找一种新的炎症指标。
1资料与方法
1.1一般资料
选取2015年4月～2016年3月本院骨科收治的60例患者作为研究对象，将其中的30例确诊细菌感染者作为感染组，包括男性16例，女性14例；年龄为18～56岁，平均(34.5±3.8)岁；创伤15例，自发感染5例。将30例行内固定物取出的健康者作为对照组，包括男性18例，女性12例；年龄为16～57岁，平均(32.2±2.5)岁。
1.2纳入与排除标准
1.2.1感染组纳入标准 ①确诊为骨科感染，感染的诊断标准参照《医院感染诊断标准》[5]，感染组患者细菌培养均为阳性；②排除其余部位存在感染灶；③可存在发热或无发热。
1.2.2对照组纳入标准 ①为骨科入院拟行取内固定物的患者；②排除其余部位感染灶存在；③体温正常，无发热。
1.2.3两组的排除标准 合并其他器官感染，如上呼吸道感染、泌尿系感染。 (郭永贤 宋世江 周献伟 房中卫 陈云浩 林雪林)