Brunkhorst F M, Karzai W, Reinhart K
Klinik für Anästhesiologie und Intensivtherapie, Klinikum der Friedrich Schiller Universität Jena, Germany.
Zentralbl Chir. 2002 Mar;127(3):165-73. doi: 10.1055/s-2002-24246.
Early diagnosis of the different severities of septic inflammation is important for early implementation of specific therapies. Sepsis and severe sepsis are accompanied by clinical and laboratory signs of systemic inflammation. However, patients suffering from non-infectious inflammation may present with similiar signs and symptoms making it difficult to diagnose infection based on clinical findings alone. Bacteriological evidence of sepsis, though definitive and specific, may not be obtainable, is time-consuming and even may not occur concurrently with clinical signs of sepsis. It is therefore important to identify markers, which, by enabling an early diagnosis of sepsis and organ dysfunction, would allow early specific therapeutic interventions. Wheras C-reactive Protein is a more sensitive parameter for the diagnosis of non-systemic infections, Procalcitonin seems to be a useful parameter to improve the diagnosis and monitoring of therapy in patients with severe sepsis and septic shock.
早期诊断不同严重程度的脓毒症炎症对于尽早实施特异性治疗很重要。脓毒症和严重脓毒症伴有全身炎症的临床和实验室体征。然而，患有非感染性炎症的患者可能表现出相似的体征和症状，这使得仅根据临床发现难以诊断感染。脓毒症的细菌学证据虽然明确且特异，但可能无法获得，耗时且甚至可能与脓毒症的临床体征不同时出现。因此，识别能够实现脓毒症和器官功能障碍早期诊断从而允许早期特异性治疗干预的标志物很重要。虽然C反应蛋白是诊断非全身性感染更敏感的参数，但降钙素原似乎是改善严重脓毒症和脓毒性休克患者诊断及治疗监测的有用参数。
