The Meaning Of Soluble Triggering Receptor Expressed On Myeloid Cells-1in Diagnosis Of Community Acquired Pneumonia

Objective To investigate the role of soluble triggering receptor expressed onmyeloid cells-1(sTREM-1) in the diagnosis and pathogenetic condition assessment ofcommunity acquired pneumonia(CAP).Methods Serum sTREM-1,CRP,Fbg, D-Dimer were determined in thirtypatients with community acquired pneumonia and twelve healthy volunteerscontrols.CAP group patients were divided into non-severe pneumonia group(22cases)and severe pneumonia group(8cases) by IDSA/ATS severe CAP criteria,divided intomild&midrange pneumonia group(25cases) and grossly pneumonia group(5cases) byCURB-65criteria,divided into low risk pneumonia group(21cases) and high riskpneumonia group(9cases) by PSI score. sTREM-1is determined by enzyme-linkedimmunosorbent assay (ELISA).CRP is determined by fully automatic biochemistryanalyser.Fbg and D-Dimer were determined by fully automatic blood clottinganalyser.All datas were analyzed by SPSS20.0statistics soft. The diagnostic value wasassessed by receiver operating characteristic(ROC)curve analysis. Subgroup analysiswas performed in pneumonia patients. The correlation between level of serumsTREM-1,CRP,Fbg,D-Dimer and CURB-65、PSI score was analyzed.Results Level of serum sTREM-1was significant higher in pneumonia groupthan in the normal control group. Level of serum CRP、Fbg、D-Dimer were higher inpneumonia group than in the normal control group,too. Level of serum sTREM-1washigher in severe pneumonia group than in non-severe pneumonia group [(122.34±24.14)ng/L vs (44.74±9.22) ng/L，P<0.05]. Level of serum sTREM-1was higher in grosslypneumonia group than in mild&midrange pneumonia group [(120.21±39.24) ng/L vs(54.48±9.87) ng/L，P<0.05]. Level of serum sTREM-1was higher in high risk pneumonia group than in low risk pneumonia group [(126.06±21.23) ng/L vs(39.45±8.08) ng/L，P<0.05]. For ROC curve in diagnosis of CAP, when the cut-offvalue of sTREM-1was set at＞15.79ng/L, the sensitivity was63.30%, specificity was83.30%, accuracy was71.40%. when the cut-off value of CRP was set at＞12.50mg/L,the sensitivity was56.70%, specificity was67.30%, accuracy was66.80%. For thedetection of combination in diagnosis of CAP, when detecting sTREM-1and CRP, thesensitivity was56.70%, specificity was91.70%, accuracy was76.20%; when detectingsTREM-1and Fbg, the sensitivity was76.70%, specificity was75.00%, accuracy was81.00%; when detecting sTREM-1and CRP and Fbg, the sensitivity was60.00%,specificity was83.30%, accuracy was78.60%.Conclusions Detection of serum sTREM-1is helpful in the diagnosis ofCAP.sTREM-1level is higher in severe pneumonia and has a positive correlation withCURB-65and PSI score. Serum sTREM-1level could help to evaluate the severity ofinfection.