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[降钙素原在外科感染诊断与监测中的应用]

[Procalcitonin in diagnosis and monitoring of surgical infections].

作者信息

Zielińska-Borkowska Urszula, Dib Naser, Tarnowski Wiesław

机构信息

Centrum Medycznego Kształcenia Podyplomowego w Warszawie, Klinika Anestezjologii i Intensywnej Terapii.

出版信息

Pol Merkur Lekarski. 2009 Dec;27(162):514-6.

Abstract

The procalcitonin (PCT) is a sensitive and reliable biochemical marker used in diagnosing and monitoring of bacterial infections. The procalcitonin assay allows for effective evaluation of the patient's health status. Elevated PCT serum level is correlated with progression and generalization of the infection. In severe infections, such as sepsis or septic shock, the PCT may reach concentrations even up to 1000 ng/ml (with a normal range below 0.1 ng/ml). High PCT levels in the first hours of the developing infection advocates for the bacterial etiology. Therefore, procalcitonin is used in differential diagnosis of severe bacterial and viral infections. Rapid and accurate diagnosis facilitates introduction of the effective therapy. Rapid decrease in PCT level after applying the therapy confirms its efficacy (control assay may be performed after 24 hours since the therapy has been applied). The usefulness of the PCT is supported by the fact, that in pathologic conditions, such as trauma (including surgery procedures), viral infections or autoimmunologic diseases, the PCT level is only slightly increased or remains in a normal range. The PCT level assay enables the detection of the developing infection already in the latent stadium, before characteristic clinical symptoms appear. Therefore, it is very important to monitor the PCT serum level. Further research will allow to determine the accurate diagnostic value and the clinical application of the PCT level as a marker of infection.

摘要

降钙素原(PCT)是一种用于诊断和监测细菌感染的敏感且可靠的生化标志物。降钙素原检测有助于有效评估患者的健康状况。血清降钙素原水平升高与感染的进展和播散相关。在严重感染,如脓毒症或脓毒性休克中,降钙素原浓度甚至可能高达1000 ng/ml(正常范围低于0.1 ng/ml)。感染初期数小时内降钙素原水平升高提示细菌感染病因。因此,降钙素原用于严重细菌感染和病毒感染的鉴别诊断。快速准确的诊断有助于开展有效治疗。治疗后降钙素原水平迅速下降证实了治疗的有效性(可在治疗开始24小时后进行对照检测)。降钙素原的有用性还体现在以下事实,即在诸如创伤(包括外科手术)、病毒感染或自身免疫性疾病等病理状况下,降钙素原水平仅略有升高或保持在正常范围内。降钙素原水平检测能够在特征性临床症状出现之前的潜伏阶段就检测到感染的发生。因此,监测血清降钙素原水平非常重要。进一步的研究将有助于确定降钙素原水平作为感染标志物的准确诊断价值和临床应用。

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