Soluble triggering receptor expressed on myeloid cells-1 as a diagnostic marker of ventilator-associated pneumonia in patients with acute ischemic stroke
10.3760/cma.j.issn.1673-4904.2017.04.014
- VernacularTitle:可溶性髓系细胞触发受体-1在不同体液中的表达对急性缺血性脑卒中患者呼吸机相关性肺炎的诊断价值研究
- Author:
Chunyan LIU
;
Zhiwen XUE
;
Jingyi WU
;
Wei XI
;
Yingjue WEI
;
Yuetian YU
- Keywords:
Pneumonia,ventilator-associated;
Soluble triggering receptor expressed on myeloid cells-1;
Bronchoalveolar lavage fluid;
Endotracheal aspiration;
Exhaled breath condensate
- From:
Chinese Journal of Postgraduates of Medicine
2017;40(4):341-346
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the potential role of soluble triggering receptor expressed on ayeloid cells-1(sTREM-1) expression in serum,endotracheal aspiration (ETA),bronchoalveolar lavage fluid (BALF) and exhaled breath condensate (EBC) as early biomarkers for the diagnosis of ventilator-associated pneumonia (VAP) in patients with acute ischemic stroke.Methods One hundred and thirty-two patients with clinically suspected VAP were prospectively included in this multicenter study.The levels of sTREM-1 in serum,ETA,BALF and EBC were analyzed for diagnostic evaluation at the time of VAP clinically suspected.The bacterial count over 104/CFU as a gold standard for VAP,and the receiver operating characteristic curves were used to identify the ideal cutoff values.Results VAP was confirmed in 76 patients (57.58％).In VAP patients (VAP group) and non-VAP patients (non-VAP group),the level of sTREM-1 in BALF was 32.35 (30.08-41.72) and 18.92(11.89-31.72) ng/L,and the level of sTREM-1 in EBC was 1.57 (1.02-2.61) and 0.41(0.19-1.61)ng/L respectively.The level of sTREM-1 in BALF and in EBC in VAP group was significantly higher than that in non-VAP group (P ＜0.05).The optimum cutoff value for sTREM-1 in BALF according to the maximum Youden index was 23.61 ng/L.This cutoff value had 85.5％ sensitivity and 73.1％ specificity,with 0.813 area under the curve.sTREM-1 in BALF had excellent correlation with that in EBC (R2 =0.78,P ＜ 0.05).Conclusions The results of this prospective study suggest that sTREM-1 levels in BALF and EBC have better roles in facilitating the diagnosis of VAP and thus may be practically recommended to guide the administration of antibiotics when VAP is suspected.
