The expression and prognostic value of serum sTREM-1, TLR4, and VCAM-1 in adult patients with severe pneumonia complicated with respiratory failure
10.3760/cma.j.cn431274-20230904-00216
- VernacularTitle:成年重症肺炎合并呼吸衰竭患者血清中sTREM-1、TLR4、VCAM-1的表达及对预后的评估价值
- Author:
Jing TIAN
1
;
Hao YUAN
Author Information
1. 长沙市第四医院呼吸与危重症医学科，长沙 410006
- Keywords:
Triggering receptor expressed on myeloid cells-1;
Toll-like receptor 4;
Vascular cell adhesion molecule-1;
Severe pneumonia;
Respiratory failure
- From:
Journal of Chinese Physician
2024;26(5):707-711
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the expression and prognostic value of serum soluble triggering receptors expressed on myeloid cells-1 (sTREM-1), Toll like receptor 4 (TLR4), and vascular cell adhesion molecule 1 (VCAM-1) in adult patients with severe pneumonia complicated with respiratory failure.Methods:A study was conducted on 80 adult patients with severe pneumonia and respiratory failure who underwent treatment at the Fourth Hospital of Changsha from January 2020 to June 2023. They were divided into a case group, and 66 surviving patients were divided into a good prognosis group and 14 deceased patients into a poor prognosis group based on their hospital survival; 72 adult patients with severe pneumonia treated in our hospital during the same period were selected as the severe pneumonia group, and 73 adult patients with simple respiratory failure were selected as the respiratory failure group. The changes in serum sTREM-1, TLR4, and VCAM-1 levels in each group of patients were analyzed, as well as the clinical scores of the three groups of patients [Clinical Pulmonary Infection Score (CPIS), Acute Physiological and Chronic Health (APACHE Ⅱ) Score]. The prognostic value of serum sTREM-1, TLR4, and VCAM-1 in evaluating the prognosis of adult severe pneumonia patients with respiratory failure was analyzed.Results:The serum levels of sTREM-1, TLR4, and VCAM-1 in the case group were significantly higher than those in the severe pneumonia group and respiratory failure group. The serum levels of sTREM-1, TLR4, and VCAM-1 in the severe pneumonia group were significantly higher than those in the respiratory failure group (all P<0.01). The CPIS and APACHE Ⅱ scores of patients in the case group were significantly higher than those in the severe pneumonia group and respiratory failure group. The CPIS and APACHE Ⅱ scores of patients in the severe pneumonia group were significantly higher than those in the respiratory failure group (all P<0.01). The correlation analysis results showed that serum levels of sTREM-1, TLR4, and VCAM-1 were positively correlated with the patient′s CPIS and APACHE Ⅱ scores (all P<0.05). The serum levels of sTREM-1, TLR4, and VCAM-1 in the poor prognosis group were significantly higher than those in the good prognosis group (all P<0.05). The results of receiver operating characteristic (ROC) curve analysis showed that the area under the ROC curve (AUC) of serum sTREM-1 in predicting the prognosis of adult severe pneumonia with respiratory failure was 0.971, with a sensitivity of 88.20% and a specificity of 91.20%; The AUC of serum TLR4 predicting the prognosis of adult severe pneumonia with respiratory failure was 0.966, with a sensitivity of 87.80% and a specificity of 92.70%; The AUC of serum VCAM-1 for predicting the prognosis of adult severe pneumonia with respiratory failure was 0.981, with a sensitivity of 89.30% and a specificity of 93.60% (all P<0.05). Conclusions:Serum sTREM-1, TLR4, and VCAM-1 are abnormally expressed in adult severe pneumonia patients with respiratory failure, and have certain prognostic value for patients.
