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目的 探究血清可溶性髓样细胞触发受体-1(sTREM-1)、降钙素原、白细胞介素-18(IL-18)在脓毒症中水平及其对疾病严重程度的评估价值.方法 选取2018年3月1日—2019年3月1日江苏省第二中医院收治的120例脓毒症患者作为观察组,选取同期收治的非感染性全身炎症反应综合征(SIRS)患者40例作为非感染性SIRS组、无脓毒症体检者40例作为对照组.根据脓毒症严重程度将观察组分为单纯脓毒症组、严重脓毒症组、脓毒症休克组.检测外周血中sTREM-1、降钙素原、IL-18水平,观察sTREM-1、降钙素原、IL-18水平与脓毒症严重程度相关性,并分析其对脓毒症诊断价值.结果 观察组外周血sTREM-1、降钙素原、IL-18水平高于非感染性SIRS组及对照组,差异有统计学意义(P＜0.05);非感染性SIRS组sTREM-1、降钙素原、IL-18水平高于对照组,差异有统计学意义(P＜0.05).脓毒症休克组外周血sTREM-1、降钙素原、IL-18水平高于严重脓毒症组和单纯脓毒症组,差异有统计学意义(P＜0.05).严重脓毒症组外周血sTREM-1、降钙素原、IL-18水平高于单纯脓毒症组,差异有统计学意义(P＜0.05).sTREM-1、降钙素原、IL-18水平联合诊断脓毒症、脓毒症休克的特异度及灵敏度高于单独诊断.在脓毒症患者中,降钙素原与IL-18水平呈正相关(r=0.29,P＜0.05).结论 脓毒症患者外周血sTREM-1、降钙素原、IL-18水平升高,且与脓毒症严重程度相关,联合检测诊断脓毒症和脓毒症休克的特异度和灵敏度高.“,”Objective To investigate the values of serum soluble myeloid cell trigger receptor-1 (sTREM-1), procalcito?nin, and interleukin-18 (IL-18) in assessment of the severity of sepsis. Methods Samples of peripheral venous blood were collected from 120 patients with sepsis (observation group), among which 61 suffered from simple sepsis, 34 from severe sepsis, and 25 from septic shock, 40 patients with non-infectious systemic inflammatory response syndrome (SIRS) (non-infectious SIRS group), and 40 persons to undergo health examination without sepsis (control group) to ex?amine the levels of sTREM-1, procalcitonin, and IL-18. The correlation of sTREM-1, procalcitonin, and IL-18 levels with the severity of sepsis was observed, and its diagnostic value for sepsis was analyzed. Results The levels of sTREM-1, procalcitonin and IL-18 in the peripheral blood of the observation group were all significantly higher than those of the non-infectious SIRS group and the control group (all P<0.05). The levels of sTREM-1, procalcitonin, and IL-18 of the non-infectious SIRS group were all significantly higher than those of the control group (all P<0.05).. The levels of sTREM-1, procalcitonin, and IL-18 in the peripheral blood of the septic shock group were all significantly higher than those of the severe sepsis group and the simple sepsis group (all P<0.05). The levels of sTREM-1, procalcitonin, and IL-18 in the peripheral blood of the severe sepsis group were all significantly higher than those of the simple sepsis group (all P<0.05). The specificity and sensitivity of diagnosing sepsis and septic shock by combined detection of sTREM-1, procalcitonin, and IL-18 were higher than those by any single item. In the patients with sepsis, procalcito?nin level was positively correlated with IL-18 level (r=0.29, P<0.05). Conclusion The levels of sTREM-1, procalcito? nin, and IL-18 in the peripheral blood are elevated in the patients with sepsis and are correlated with the severity of sepsis. The specificity and sensitivity of diagnosing sepsis and septic shock by combined detection of sTREM-1, procal?citonin, and IL-18 were higher than those by a single item.