The Diagnostic Value Of Detecting The Peripheral Blood Serum PCT、IL-17 、sTREM-1 Levels In The Patients With VAP

Objective : Detect the changes of peripheral blood serum PCT、IL-17 and s TREM-1levels in patients receiving mechanical ventilation and being to be VAP,to explore the diagnostic value of PCT 、 IL-17 and s TREM-1 levels in patients with ventilator associated pneumonia(VAP).Methods: During April 2015 to 2016 April,collect the 61 patients receiving mechanical ventilation and being to be VAP as the research sample in ICU of our hospital.the samples without mechanical ventilation as the MV0 h,and collecting the peripheral blood.The samples with mechanical ventilation for 48 hours and not occurred VAP as the MV-NVAP,and collecting the peripheral blood.Once definitive diagnosed VAP as the VAP.The observation time window for 7 days,patients with no VAP occurred within7 days to be excluded.Collecting the peripheral blood,PCT、IL-17 and s TREM-1 levels are detected by ELISA method,and the results use SPSS18.0 statistical software to test.Results: The MV-NVAP serum samples of PCT,IL-17 and s TREM-1 levels were higher than the groups of MV0 h,P>0.05,each of them have no statistical significance.The VAP serum samples of PCT、IL-17 and s TREM-1 levels were significantly higher than the MV0h、MV-NVAP,P<0.05,each of them have statistical significance.The area under the ROC curve of PCT was 0.856.When the serum PCT level reached104.7864pg/ml,the sensitivity of the diagnosis of VAP was 73.9%,and the specificity was 84.4%.The area under the ROC curve of IL-17 was 0.877.When the serum IL-17 level reached 136.9726pg/ml,the sensitivity of the diagnosis of VAP was 70.8%,and the specificity was 91.7%.The area under the ROC curve of s TREM-1 was 0.813.When the serum s TREM-1level reached 95.4204pg/ml,the sensitivity of the diagnosis of VAP was 72.4%,and the specificity was 79.3%.ROC results showed that the sensitivity and specificity of the combined indicators of PCT、IL-17 for the diagnosis of VAP were78.7% and 71.0%.The area under the ROC curve was 0.816.ROC results showed that the sensitivity and specificity of the combined indicators of PCT、s TREM-1 for the diagnosis of VAP were 82.0% and 54.8%.The area under the ROC curve was 0.791.ROC results showed that the sensitivity and specificity of the combined indicators of IL-17、s TREM-1 for the diagnosis of VAP were 78.7% and 71.0%.The area under the ROC curve was 0.812.ROC results showed that the sensitivity and specificity of the combined indicators of PCT,IL-17 and s TREM-1 for the diagnosis of VAP were 84.4%and 90.6%.The area under the ROC curve was 0.973.Conclusions: After 48 hours of mechanical ventilation,mechanical ventilation due to mechanical damage may cause the patient’s PCT、IL-17 and s TREM-1 levels increased.Combing PCT with IL-17 to diagnose VAP,the diagnostic sensitivity is higher than the single index but the specificity is lower slightly.Combing PCT with s TREM-1 to diagnose VAP,the diagnostic sensitivity is higher than the single index significantly but the specificity is lower.Combing IL-17 with s TREM-1 to diagnose VAP,the diagnostic sensitivity is higher than the single index but the specificity is lower slightly.Combing PCT with IL-17 and s TREM-1to diagnose VAP,the diagnostic sensitivity is higher than the single index and the two joint index significantly,the specificity is higher than PCT,s TREM-1 and the two joint index,but lower than IL-17 slinghtly.The peripheral blood serum PCT 、 IL-17 and s TREM-1level of in patients with VAP all have a certain diagnostic value.