Study On The Value Of Serum STREM-1,PCT And CRP Levels Combined With PSI And CURB65 Score In The Diagnosis Of Severe Pneumonia

Objective: The aim was to investigate the value of serum soluble myeloid trigger receptor-1(sTREM-1),calcitoninogen(PCT),C-reactive protein(CRP)levels,pneumonia severity index(PSI)score and CURB65 score alone and in combination in the diagnosis of severe community-acquired pneumonia(SCAP).Methods: A total of 156 patients were included in this study.Seventy-six patients with community-acquired pneumonia(CAP)and 40 patients with SCAP were selected from the Department of Respiratory Medicine,Yulin First Hospital,from October 2021 to November 2022.Forty subjects in the control group were selected from our physical examination center.The serum sTREM-1,PCT,and CRP levels of all subjects on the 1st day of enrollment were detected,and the general conditions,underlying diseases,vital signs,clinical symptoms,signs,and relevant auxiliary examination results were collected.The PSI score and CURB65 score were calculated based on the collected data,and the diagnostic effect of individual and combined indexes on severe community-acquired pneumonia and the correlation between the indexes were analyzed.Results: In the SCAP group,serum sTREM-1 was 398.868(308.021,737.286)pg/ml,PSI was 90.500(71.250,110.000)points,CURB65 was 2(1,2)points,leukocytes were 9.650(7.213,15.500)U/L,PCT was 0.517(0.091,3.338)ng/ml,and IL-6 was 113.550(45.343,334.250)pg/ml,all of which were significantly higher than those in the CAP group(P < 0.05).In addition,these serum markers were positively correlated with PSI score and CURB65.ROC curve analysis showed that the area under the ROC curve AUC of sTREM-1(0.746)was higher than that of leukocytes(0.621),CRP(0.569)and PCT(0.736),and lower than that of PSI(0.777),CURB65(0.849)and IL-6(CURB65 had the highest AUC value(0.849).The area under the ROC curve analysis was performed after combining sTREM-1 with PSI score,CURB65 score,PSI and CURB65 score,and PCT,respectively,and the area under the curve was 0.806,0.888,0.890,and 0.768,respectively.sTREM-1 combined with PSI score and CURB65 score had an area under the curve of 0.836.,the highest AUC value(0.890)was obtained for CURB65.The Kruskal-Wallis H(K)test was performed on the area under the curve,and none of the differences were statistically significant(p > 0.05).No statistically significant differences were considered in the diagnostic efficacy of the three for severe pneumonia.Conclusion: 1.sTREM-1,PCT,PSI score and CURB65 score have positive application value in the differentiation of common pneumonia from severe pneumonia.2.sTREM-1 can be used to assess the severity of community-acquired pneumonia and can provide reference for clinical diagnosis and treatment.3.sTREM-1 combined with PCT,PSI score and CURB65 score respectively can further improve the diagnostic efficacy of severe pneumonia.sTREM-1 combined with PSI and CURB65 score plotted an area under the ROC curve of 0.890,which had the highest diagnostic efficacy for severe pneumonia.4.sTREM-1,PSI score,CURB65 score,and PCT were positively correlated with the severity of severe pneumonia,and the higher the indexes,the stronger the basis for the diagnosis of severe the more severe the pneumonia.