The Early Prediction Value Of STREM-1 On Severe Acute Pancreatitis

Background: In recent 10 years,there is an upward trend in the incidence of SAP,illness weight,progress rapidly,high mortality rate.Early recognition and early effective strengthening nursing intervention,liquid recovery,can change the course of the disease,patients with shorter hospital stay.At present,no simple and feasible method for early prediction of SAP has been found in clinical practice.Previous studies have found that soluble myeloid cells trigger receptor 1(sTREM-1)in patients with infectious and non-infectious inflammation in serum increased to different extent,and the severity of the disease and the patient’s activity Objective:By detecting strem-1 level in serum of patients with acute pancreatitis,the early prediction value of strem-1 for SAP and the optimal threshold parameter for the diagnosis of SAP were discussed.The correlation between sTREM-1 and scoring system was analyzed.To investigate the value of sTREM-1 in early prediction of AP prognosis and hospital stay.Methods: collecting AP patients admitted to the emergency department of Rui Jin hospital for emergency treatment within 72 h from 2016 to 2018.Patients meeting the inclusion criteria were included.According to the latest classification standards of Atlanta,It can be divided into mild MAP,MSAP,SAP and the control group.After the collection of samples,sTREM-1 concentration in serum was detected by enzyme-linked immunosorbent assay(ELISA).The sensitivity and specificity of strem-1 in the diagnosis of SAP were analyzed by ROC curve,and the optimal boundary value of strem-1 in the diagnosis of SAP was analyzed by Jordan index.Linear regression analysis was used to explore the correlation between sTREM-1 and acute physiological and chronic health scoring system(APACHEII)and modified CT severity(CTSI).ROC curve was used to analyze the specificity and sensitivity of strem-1 level in early prediction of AP patients’ hospitalization time at 4-8weeks and the optimal diagnostic threshold.Results: Within three days of onset,the early serum sTREM-1 >level(0.490ng/ml)in patients with acute severe pancreatitis was significantly higher than that in patients without severe pancreatitis(0.281ng/ml),acute mild pancreatitis(0.394 ng/ml)and acute moderate severe pancreatitis(0.425 ng/ml),and P<0.05 was statistically significant;The ROC curve was drawn,and the area under the curve(AUC)of sTREM-1 in diagnosing SAP was 0.926.When strem-1 > was 0.40ng/ml,the diagnostic specificity and sensitivity for SAP were 0.75 and 0.95.STREM-1 was positively correlated with APACHEII score and CTSI score,and the correlation was 0.404(P<0.05)and 0.752(P<0.05).When sTREM-1 >0.480ng/ml,the mortality of patients was significantly increased,with an AUC of 0.971,a specificity of 0.857,and a sensitivity of 1.0.When strem-1 >0.419ng/m,the AUC diagnosed at 1-2 months of hospitalization was 0.694,and the specificity and sensitivity were 0.53 and 0.84,respectively.Conclusion:STREM-1 was significantly increased in SAP patients,which was of certain significance for the early diagnosis of SAP.When strem-1 >0.40ng/ml,the specificity and sensitivity of the diagnosis of SAP were 0.75 and 0.95.STREM-1 is related to the patient’s condition,length of stay and mortality.When sTREM-1 > is 0.480ng/ml,it has reference value for poor prognosis.Moreover,when sTREM-1 >0.419ng/ml,it has a certain guiding value in predicting the hospitalization time of patients at 2-4 months.