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首页> 外文期刊>Chest: The Journal of Circulation, Respiration and Related Systems >Diagnostic implications of soluble triggering receptor expressed on myeloid cells-1 in BAL fluid of patients with pulmonary infiltrates in the ICU.
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Diagnostic implications of soluble triggering receptor expressed on myeloid cells-1 in BAL fluid of patients with pulmonary infiltrates in the ICU.

机译：ICU肺浸润患者BAL液中髓样细胞1上表达的可溶性触发受体的诊断意义。

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OBJECTIVE: Prospective single-center study to determine whether the presence of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) has diagnostic utility in patients with pulmonary infiltrates receiving mechanical ventilation and undergoing BAL. DESIGN: Prospective cohort study. SETTING: Barnes-Jewish Hospital, a 1,200-bed urban teaching hospital. PATIENTS: Adult patients with acute respiratory failure undergoing BAL for pulmonary infiltrates. INTERVENTIONS: BAL fluid measurement of sTREM-1 concentration using a Quantikine Human TREM-1 Immunoassay (R&D Systems; Minneapolis, MN). Measurements and main results: A total of 105 consecutive patients receiving mechanical ventilation and undergoing BAL were enrolled. Of those, 19 patients (18.1%) met definite microbiologic criteria for bacterial or fungal ventilator-associated pneumonia (VAP). Though the mean sTREM-1 concentration was greater in patients with definite VAP (n = 19; 171.9 +/- 158.7 pg/mL) than in patients with definite absence of VAP (n = 21; 96.7 +/- 76.2 pg/mL), this difference was not statistically significant (p = 0.06). A cutoff value for sTREM-1 > 200 pg/mL yielded a diagnostic sensitivity of 42.1% and a specificity of 75.6% for definite VAP. Patients with alveolar hemorrhage had the greatest values for sTREM-1 concentration (n = 9; 555 +/- 440 pg/mL). Receiver operating curve analysis and multivariate logistic regression analysis demonstrated that measurement of sTREM-1 was inferior to clinical parameters for the diagnosis of VAP. CONCLUSIONS: Measurement of sTREM-1 in BAL fluid appears to have minimal diagnostic value for VAP.
机译：目的：前瞻性单中心研究确定髓样细胞-1（sTREM-1）上表达的可溶性触发受体是否对具有机械通气并接受BAL的肺浸润患者具有诊断价值。设计：前瞻性队列研究。地点：巴恩斯犹太医院，拥有1200张病床的城市教学医院。患者：患有急性呼吸衰竭的成人患者因肺浸润而接受BAL治疗。干预措施：使用Quantikine人类TREM-1免疫测定法（R＆D Systems;明尼阿波利斯，明尼苏达州）对sTREM-1浓度进行BAL液测量。测量和主要结果：总共纳入了105例接受机械通气并接受BAL的患者。在这些患者中，有19名患者（18.1％）符合确定的细菌或真菌呼吸机相关性肺炎（VAP）微生物学标准。尽管确诊VAP的患者（n = 19; 171.9 +/- 158.7 pg / mL）的平均sTREM-1浓度要高于确诊VAP的患者（n = 21; 96.7 +/- 76.2 pg / mL） ，则该差异在统计学上不显着（p = 0.06）。 sTREM-1的临界值> 200 pg / mL，对于确定的VAP，诊断灵敏度为42.1％，特异性为75.6％。肺泡出血患者的sTREM-1浓度最高（n = 9; 555 +/- 440 pg / mL）。接受者工作曲线分析和多因素logistic回归分析表明，sTREM-1的测量不如用于诊断VAP的临床参数。结论：测量BAL液中sTREM-1对VAP的诊断价值极低。

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