Soluble Triggering Receptor Expressed On Myeloid Cell-1 In Diagnosis Of Ventilator-Associated Pneumonia And Its Clinical Significance

Objective To explore the diagnostic role of soluble triggering receptor expressed on myeloid cells-1(sTREM-1) in ventilator associated pneumonia (VAP).Method Patients were divided into three groups:15 cases of VAP,13 cases of non-VAP and 10 cases of healthy control subjects.Levels ofsTREM-1 in serum and endotracheal aspirate(ETA) were measured by Enzyme-linked immunosorbent assay(ELISA),meanwhile C-reactive protein(CRP),Clinical Pulmonary Infection Score(CPIS) and White Blood Cell(WBC) were examined before treatment,after 5 days therapy and 10 days therapy respectively in three groups.Results In VAP group,levels of sTREM-1 in serum and ETA,CPIS,WBC and CRP increased significantly before treatment than 5 days therapy and 10 days therapy,there was a significant difference compared with other groups (P＜0.01).After successful therapy(infection control),sTREM-1,CPIS,WBC and CRP in patients of VAP decreased towards normal level.After 10 days therapy, sTREM-1,CPIS,WBC and CRP had no difference between VAP group and non-VAP group(P＞0.05).While levels of sTREM-1 in serum had no difference between non-VAP group and healthy control group(P＞0.05).Receiver operating characteristic(ROC) curve was analyzed,if 172 pg/ml sTREM-1 in ETA was selected to be a break point of the diagnosis of VAP,sensitivity was 88%and specificity was 84%.Conclusion Level of sTREM-1 in ETA is a potential diagnostic biomarker of VAP.When Level of sTREM-1 increased to 172ng/ml.The sensitivity and specificity of the diagnosis of VAP are both high.The level of sTREM-1 in ETA decreases towards normal level quickly after antibiotic treatment,sTREM-1 in ETA can be a tool to judge the therapeutic effect.