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脓毒症的诊断和预后标志物。

Diagnostic and prognostic markers in sepsis.

机构信息

Department of Intensive Care, Erasme Hospital, Université libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium.

出版信息

Expert Rev Anti Infect Ther. 2013 Mar;11(3):265-75. doi: 10.1586/eri.13.9.

Abstract

Sepsis is a common and serious complication in intensive care unit patients. An important factor in optimizing survival rates in septic patients is the ability to start treatment early in the course of disease; there is, therefore, a need for accurate diagnostic tests. In recent years, there has been a move away from the rather vague and nonspecific signs that were previously used to diagnose sepsis towards the possible adjunctive role of biomarkers. Many biomarkers have been proposed and assessed clinically, but none alone is specific enough to definitively determine diagnosis. The future direction of research is most likely a greater focus on the use of panels or combinations of markers with clinical signs. Some biomarkers may also be useful for prognosis and guiding therapy. Here, the authors will review our changing approaches to sepsis diagnosis and discuss some of the markers that seem most relevant at the present time.

摘要

脓毒症是重症监护病房患者中常见且严重的并发症。优化脓毒症患者存活率的一个重要因素是能够在疾病早期开始治疗;因此,需要准确的诊断测试。近年来,人们已经不再使用以前用于诊断脓毒症的那些相当模糊和非特异性的体征,而是转向生物标志物的可能辅助作用。已经提出并临床评估了许多生物标志物,但没有一种具有足够的特异性来明确确定诊断。未来的研究方向很可能更加侧重于使用标志物组合与临床体征的联合。一些生物标志物也可能对预后和指导治疗有用。在这里,作者将回顾我们对脓毒症诊断方法的改变,并讨论目前最相关的一些标志物。

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