Clinical Significance Of Serum Soluble Triggering Receptor Expressed On Myeloid Cells 1 Level In Early Diagnosis And Prognosis Of Cirrhotic Patients With Systemic Inflammatory Response Syndrome

Objective To investigate the significance of serum soluble triggering receptor expressed on myeloid cells-1(sTREM-1)level in early diagnosis and prognosis of cirrhosis with systemic inflammatory response syndrome(SIRS).Methods In the first stage,We analysed the expression level of serum sTREM-1.We ended up to collect 178 cases,they were divided into four groups:45 cirrhotic patients with SIRS(group A),50 cirrhotic patients without SIRS(group B),43 SIRS without cirrhosis(group C)and 40 healthy people as a control group(group D).We Collected the clinical data including liver function,serum creatinine,blood routine and prothrombin time,CRP and PCT.ELISA method was used to detect the level of serum sTREM-1 in each group.We analyzed and compared the clinical data of group A and B.We evaluated the diagnostic value of serum sTREM-1 level in cirrhosis with SIRS by receiver operating characteristic curve(ROC)analysis.The patients were divided into survival group and death group by the outcome of the disease in 90 days follow-up.We analyzed the difference between survival group and death group of inflammatory markers in group A.In the second stage,we assessed the expression level of serum TREM-1mRNA.We collected a total of 46 cases.they were divided into two groups:25 cirrhotic patients with SIRS(group I),21 cirrhotic patients without SIRS(group II).We used Quantitative Real-time PCR(RT-qPCR)method to detect the gene level of serum TREM-1 mRNA of patients in group I and group II.We analyzed and compared the differences of the two group.Results 1.The age(P<0.05),total bilirubin(P<0.05),serum creatinine(P<0.01),prothrombin time(P<0.01),child-pugh C ratio(P<0.01)and mortality(P<0.01)in group A were higher than those in group B.2.The white blood cell count,neutrophil ratio,hypersensitive c reactive protein,procalcitonin and serum sTREM-1 in group A were significantly higher than those in group B(P<0.01).3.The ROC’s area under the curve of WBC、GR、CRP、PCT、sTREM-1 was 0.716、0.775、0.870、0.850、0.966,respectively;The sensitivity and specificity of sTREM-1 were 0.860、0.956,respectively;4.The cut off value of WBC、GR、CRP、PCT、sTREM-1 was 6.37×1O9/L、76.3%、18.7mg/L、0.48ng/L、233.78pg/ml.5.In group A,there was no statistical differences in WBC、CRP between survival group and dead group(P>0.05),The level of GR、PCT、sTREM-1 in the dead group was higher than that in the surviving group(P<0.05).In the two groups,the level of serum TREM-1mRNA expression in group I were significantly higher than those in group Ⅱ(p<0.01).6.The level of TREM-1mRNA expression in group I were significantly higher than those in group Ⅱ(p<0.05).conclusion 1.The serum sTREM-1 level in the early diagnosis of liver cirrhosis with sirs was higher than that of WBC,GR、CRP、PCT.2.Serum sTREM-1>233.78pg/ml showes that SIRS may be occurring in liver cirrhosis,and its level is related to the prognosis of the patients.3.The increased expression of serum sTREM-1 mRNA is helpful for the diagnosis of cirrhosis with SIRS.