Department of General Intensive Care, University Hospital Centre of Liege, Domaine universitaire du Sart-Tilman, 4000, Liege, Belgium,
Curr Infect Dis Rep. 2013 Oct;15(5):394-9. doi: 10.1007/s11908-013-0360-2.
Procalcitonin (PCT), a 116-aminoacids prohormone, has been substantially studied over the last 2 decades in the field of sepsis. Disappointingly low sensitivity values led to the abandonment of the concept of it as a diagnostic tool and then to its being considered more as a prognostic marker with a good correlation with severe infection. Later on, growing concerns about multidrug-resistant bacteria in the ICU environment and about the cost and side effects of antibiotics suggested that PCT might prove to be a valuable asset in stewardship programs. Numerous but hardly comparable randomized controlled trials assessing either initiation or deescalation in ICU patients have been published. Stewardship encompassing PCT should focus on the latter, because of the high negative predictive value of this biomarker. However, there still would be safety concerns if a systematic implementation of PCT were to be considered in daily stewardship programs in the ICU, especially in extra-thoracic sepsis.
降钙素原（PCT）是一种 116 个氨基酸的前激素，在过去的 20 年中，在脓毒症领域进行了大量研究。其较低的灵敏度值导致人们放弃了将其作为诊断工具的概念，转而将其更多地视为一种与严重感染具有良好相关性的预后标志物。后来，人们对 ICU 环境中多药耐药菌的日益关注，以及对抗生素的成本和副作用的关注，表明 PCT 可能成为管理计划中的有价值的工具。已经发表了许多评估 ICU 患者开始或降级治疗的随机对照试验，但这些试验几乎无法进行比较。由于这种生物标志物具有很高的阴性预测值，因此包含 PCT 的管理应侧重于后者。然而，如果在 ICU 的日常管理计划中系统地实施 PCT，特别是在胸外脓毒症中，仍会存在安全问题。
