ten Boekel Edwin, Vroonhof Karen, Huisman Albert, van Kampen Corine, de Kieviet Wim
Clinical Laboratory, Sint Lucas Andreas Hospital, P.O. Box 9243, 1006 AE Amsterdam, The Netherlands.
Clin Chim Acta. 2006 Oct;372(1-2):1-13. doi: 10.1016/j.cca.2006.03.024. Epub 2006 May 12.
The diagnostic approach and the clinical management of critically ill patients is challenging. The recognition of biomarkers related to in-hospital mortality is of importance for identification of patients at increased risk of death. Many prediction models assessing the severity of illness and likelihood of hospital survival were developed using logistic regression analyses. These models include several laboratory parameters, such as white blood cell counts, serum bilirubin, serum albumin, blood glucose, serum electrolytes and markers which reflect acid-base disturbances. Recently, several other biomarkers, including troponin, B-type natriuretic peptide (BNP), N-terminal proBNP, C-reactive protein, procalcitonin, cholesterol and coagulation related markers have emerged as clinically useful tools for risk stratification and mortality prediction of heterogeneous and more specific subgroups of critically ill patients. More investigations are required to verify whether risk stratification based on mortality-related biomarkers may translate into targeted treatment strategies to improve clinical outcome of the critical illness. Biomarkers which are related to in-hospital mortality are highlighted in the current review.
危重症患者的诊断方法和临床管理具有挑战性。识别与院内死亡率相关的生物标志物对于确定死亡风险增加的患者至关重要。许多使用逻辑回归分析开发的评估疾病严重程度和医院生存可能性的预测模型。这些模型包括几个实验室参数，如白细胞计数、血清胆红素、血清白蛋白、血糖、血清电解质以及反映酸碱紊乱的标志物。最近，其他几种生物标志物，包括肌钙蛋白、B型利钠肽（BNP）、N末端proBNP、C反应蛋白、降钙素原、胆固醇和凝血相关标志物，已成为危重症患者异质性和更特定亚组风险分层和死亡率预测的临床有用工具。需要更多的研究来验证基于与死亡率相关的生物标志物的风险分层是否可以转化为针对性的治疗策略，以改善危重症的临床结局。本综述重点介绍了与院内死亡率相关的生物标志物。
