| Objective To study the diagnostic value of combined detection of serum pattern recognition receptor expression level on blood stream infection(BSI) sepsis. Methods A total of 242 patients with sepsis admitted from January 2021 to July 2022 in the First Affiliated Hospital of Hebei North University were selected as subjects. Before anti infection therapy, the levels of toll like receptor 2(TLR2), toll like receptor 4(TLR4), and NOD-like receptor protein 3(NLRP3) in serum were detected, and blood culture was conducted. The patients were divided into BSI group(n=178) and non BSI group(n=64) according to the blood culture results, and BIS group was divided into patients with Gram positive bacteria(G+) infection(n=65) and patients with Gram negative bacteria(G-) infection(n=113). The diagnostic value of serum TLR2, TLR4, and NLRP3 levels for BSI was analyzed by the receiver operating characteristic(ROC) curve. Results The serum TLR2(8.37±1.46) pg/mL, TLR4(11.25±2.21) pg/mL, NLRP3(766.97±150.08) ng/mL levels in BSI group were higher than(6.49±0.75) pg/mL, (8.78±2.10) pg/mL, (619.65±150.33) ng/mL in non BSI group(P<0.05). The serum TLR2(8.92±1.41) pg/mL, TLR4(11.86±2.07) pg/mL, NLRP3(824.39±129.43) ng/mL levels of G-patients were higher than(7.40±1.44) pg/mL, (10.19±1.93) pg/mL, (667.15±119.94) ng/mL of G+ patients in BSI group(P<0.05). The serum TLR2, TLR4 and NLRP3 levels in BSI group and non BSI group were positively correlated with APACHE II score and SOFA score. The AUC of serum TLR2, TLR4, NLRP3 in the diagnosis of BSI sepsis was 0.857, 0.789, 0.75, respectively, and the AUC of the three indicators in combination was 0.934, the sensitivity and specificity of the combination of three indicators was 90.63% and 87.08% respectively. The AUC of serum TLR2, TLR4, NLRP3 in the diagnosis of G- infection in BSI sepsis was 0.780, 0.722, 0.816, respectively, and the AUC of the three indicators in combination was 0.934, the sensitivity and specificity of the combination of three indicators was 82.46% and 83.08% respectively. Conclusions The combined detection of serum TLR2, TLR4 and NLRP3 has diagnostic value for BSI sepsis and bacterial infection types. |
