https://scholars.lib.ntu.edu.tw/handle/123456789/510436
標題: | Serum soluble triggering receptor expressed on myeloid cells-1 in acute respiratory distress syndrome: A prospective observational cohort study | 作者: | Lin M.-T. Wei Y.-F. SHIH-CHI KU Lin C.-A. CHAO-CHI HO CHONG-JEN YU |
公開日期: | 2010 | 出版社: | Elsevier B.V. | 卷: | 109 | 期: | 11 | 起(迄)頁: | 800-809 | 來源出版物: | Journal of the Formosan Medical Association | 摘要: | Background/Purpose: Serum soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), a detector of acute inflammatory response to microbial products and a good marker for diagnosing sepsis and pneumonia, has not yet been described as a predictor for infection or a prognostic factor in patients with acute respiratory distress syndrome (ARDS). Methods: This prospective observational cohort study enrolled 63 ventilated adult patients with ARDS; 50 as septic and 13 as non-septic, and followed them for 28 days in intensive care units at a university hospital in Taiwan. Serial serum sTREM-1 levels and cytokines, such as interleukin (IL)-1, IL-8, and tumor necrosis factor-α, on days 1, 3, 5, 7 and 14 were measured by an enzyme-linked immunosorbent assay. The association between biomarkers and clinical infectious diagnosis/outcome in ARDS was explored. Results: Serum sTREM-1 and cytokine levels could not differentiate septic from non-septic ARDS. Serum log sTREM-1 and inflammatory cytokine levels were correlated positively (r = 0.325 for IL-1β; r = 0.247 for IL-8; r = 0.480 for tumor necrosis factor-α). As prognostic factors, higher serum sTREM-1 level on day 1 and increasing levels over time, especially in the first 5 days, were independent predictors of mortality on day 28, using a multivariate Cox regression model. Serum sTREM-1 levels remained stable or even increased in the non-surviving patients, but decreased in the survivors. Conclusion: Serum sTREM-1 level might not be a reliable marker for infection in ARDS patients. However, as an inflammatory marker, initial serum sTREM-1 level and its trend over time, especially in the first 5 days, could be predictive of short-term mortality. A progressive decline in serum sTREM-1 levels during followup indicates a favorable outcome, whereas persistently elevated sTREM-1 indicates a poor prognosis and should lead to a re-evaluation of therapy. ? 2010 Elsevier & Formosan Medical Association. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-79951910023&doi=10.1016%2fS0929-6646%2810%2960125-8&partnerID=40&md5=5f1350084726887bd88a6635ca0b919d https://scholars.lib.ntu.edu.tw/handle/123456789/510436 |
ISSN: | 0929-6646 | DOI: | 10.1016/S0929-6646(10)60125-8 | SDG/關鍵字: | biological marker; cytokine; interleukin 1; interleukin 1beta; interleukin 8; triggering receptor expressed on myeloid cells 1; tumor necrosis factor alpha; adult; adult respiratory distress syndrome; aged; article; blood level; cohort analysis; controlled study; diagnostic test accuracy study; enzyme linked immunosorbent assay; female; human; independent variable; inflammation; major clinical study; male; observational study; pneumonia; prognosis; proportional hazards model; prospective study; reliability; sepsis; Taiwan |
顯示於: | 醫學系 |
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