Levels of sTREM (Soluble Triggering Receptor Expressed on Myeloid Cells)-1 in Pleural Effusion as an Indicator of Pulmonary Bacterial Infection

肋膜積液中骨髓細胞表達的可溶解觸發受體(sTREM-1)值可做為肺部細菌感染的指標

魏裕峰(Yu-Feng Wei) ； 謝國洲(Kou-Chou Hsieh) ； 古世基(Shih-Chi Ku) ； 王誠一(Cheng-Yi Wang) ； 何肇基(Chao-Chi Ho) ； 余忠仁(Chong-Jen Yu) ； 楊泮池(Pan-Chyr Yang)

《胸腔醫學》 21卷5期 (2006/10) Pp. 406-412

https://doi.org/10.29806/TM.200610.0002

摘要

背景：在支氣管肺泡灌洗液中，骨髓細胞表達的可溶解觸發受體(sTREM-1)的有無，可作為接受呼吸器患者是否有肺部感染的指標。但是在肋膜積液中，sTREM-1值所扮演的的角色尚未明朗。
方法：這是一個前瞻性的觀察研究，總共有25位患者分為兩組為研究對象。13位為細菌性肺炎相關肋膜積液及12位為滲出性肋膜積液的患者。我們利用酵素連結免疫吸附分析的方法測出肋膜積液中sTREM-1的濃度。統計上則是利用t-test來比較兩組的差異，並利用ROC曲線分析來決定兩組的臨界值，
結果：在肺炎相關的肋膜積液中sTREM-1濃度值比滲出性的肋膜積液為高(p=0.023)。在肋膜積液中，sTREM-1的最佳診斷臨界值為29.69pg/ml，以用來區分細菌性肺炎相關或滲出性的肋膜積液，其靈敏度及特異度分別為75%及100%。
結論：在細菌陸肺炎相關的肋膜積液中sTREM-1有較高的濃度，並可作為其指標。對於sTREM-1值在其他菌種的感染及病患預後的影響則需進一步的研究來釐清。

關鍵字

骨髓細胞表達的可溶解觸發受體sTREM-1 ； 肋膜積液

並列摘要

Background: The presence of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in bronchoalveolar fluid in patients receiving mechanical ventilation can be an indicator of pneumonia. The diagnostic role of sTREM-1 in pleural effusion for patients with pulmonary bacterial infection is still uncertain.
Methods: We performed a prospective observational study. A total of 25 patients were enrolled and divided into 2 groups: 13 with bacterial parapneumonic effusion and 12 with transudative effusion. The sTREM-1 concentration in pleural effusion was measured by a sandwich enzyme-linked immunosorbent assay. Unpaired Student's t tests were used to compare the differences between the groups. Receiver operator characteristic analysis was performed to determine the optimal cut-off value.
Results: Levels of sTREM-1 in pleural effusion were significantly higher in parapneumonic effusion than in transudative effusion (p=0.023). The optimal diagnostic value of sTREM-1 in discriminating parapneumonic from transudative pleural effusion was set at 29.69pg/mL, with a sensitivity and specificity of 75% and 100%, respectively.
Conclusions: A higher concentration of sTREM-1 in pleural effusion is a useful indicator for the detection of bacterial parapneumonic effusion. Further studies are warranted to clarify its role in discriminating different pathogens and predicting patient outcomes.

並列關鍵字

soluble triggering receptor expressed on myeloid cells ； pleural effusion