Hatzistilianou Maria
School of Medicine, Aristotle University of Thessaloniki, Greece.
ScientificWorldJournal. 2010 Oct 1;10:1941-6. doi: 10.1100/tsw.2010.181.
Despite several consensus conferences, the criteria for the definition of sepsis are still considered too sensitive and insufficiently specific. The traditional clinical signs of infection and routine laboratory tests used to diagnose bacterial infection and sepsis lack diagnostic accuracy and can be misleading, particularly in patients with immunodeficiencies. The problems with sepsis definitions and diagnoses are indications of the need to focus on biochemical mediators capable not only of distinguishing the inflammatory response to infection from other types of inflammation, but also of indicating the severity and prognosis of the disease. Thus, physicians need an early and rapid marker for detecting bacterial infection and distinguishing it from viral infection. Several studies revealed that elevated procalcitonin (PCT) levels in human blood could be detected in cases of sepsis and bacterial infection. PCT is a protein that can act as a hormone and a cytokine. It can be produced by several cell types and many organs in response to proinflammatory stimuli, particularly bacterial infection. It provides a rapid diagnostic test, available at the patient's bedside, and its half-life is suitable for daily monitoring of the disease progress.
尽管召开了多次共识会议，但脓毒症的定义标准仍被认为过于敏感且特异性不足。用于诊断细菌感染和脓毒症的传统感染临床体征及常规实验室检查缺乏诊断准确性，可能会产生误导，尤其是在免疫缺陷患者中。脓毒症定义和诊断方面的问题表明，有必要关注那些不仅能够区分感染性炎症反应与其他类型炎症，还能指示疾病严重程度和预后的生化介质。因此，医生需要一种早期快速的标志物来检测细菌感染并将其与病毒感染区分开来。多项研究表明，脓毒症和细菌感染患者的血液中可检测到降钙素原（PCT）水平升高。PCT是一种可充当激素和细胞因子的蛋白质。它可由多种细胞类型和许多器官在对促炎刺激（尤其是细菌感染）作出反应时产生。它提供了一种可在患者床边进行的快速诊断检测方法，其半衰期适合对疾病进展进行日常监测。
