The Early Diagnostic Value Of Soluble Triggering Receptor-1myeloid Cell And CD64in Sepsis

Objective To observe the early diagnostic value of serum sTREM-1(soluble triggering receptor expressed on myeloid cell-1) and the level of neutrophil surface CD64in patients with sepsis.Methods The study was conducted in The First Hospital of Lanzhou University.55patients with systemic inflammatory response syndrome were enrolled, sepsis (n=35), non-infection SIRS (n=20). In addition,10healthy volunteers served as controls. Their blood samples were obtained for sTREM-1and CD64measurement. STREM-1was measured by double-antibody sandwich enzyme-linked Immunosorbent Assay (ELISA).CD64was measured by automatic flow cytometry. STREM-1and CD64were described as median; data analysis was carried out in software SPSS16.0. We using receiver operating characteristic curve (ROC) evaluation of the indicators of sepsis diagnostic accuracy.Results Serum sTREM-1median concentrations in sepsis, non-infectious SIRS and control is255.34pg/ml、184.58pg/ml and128.64pg/ml, respectively. The level of sTREM-1in patients with sepsis were significantly higher than patients with non-infectious SIRS and control(P<0.01);the levels of peripheral blood neutrophil CD64in the sepsis (79.96%) was significantly higher than that in the other two groups(47.50%,16.37%)(P<0.05).The area under the ROC curve of sTREM-1for the diagnosis of sepsis was0.75(95%CI,0.63-0.88)(P=0.002), the cut-off level was208.86pg/mg, sensitivity74%and specificity70%. At cut-off level of57.83%, The levels of CD64showed sensitivity of85%, specificity of75%. The area under the ROC curve for the diagnosis of sepsis was0.77(95%CI,0.76-0.96)(P<0.001).The area under the ROC curve of combination was0.86(95%CI0.75-0.96), sensitivity is90%and positive predictive value is98%.Conclusion The level of sTREM-1in patients with sepsis was significantly higher than patients with non-infectious SIRS and control, indicating that sTREM-1have diagnostic value on early sepsis. The levels of peripheral blood neutrophil CD64in the sepsis was significantly higher than that in the other two groups, indicating that CD64might be an effective diagnostic marker. Combining two biomarkers has a better diagnostic value. The change of sTREM-1was more sensitive in evaluation of pneumonia.