Department of Anesthesiology and Intensive Care Medicine; Jena University Hospital; Jena, Germany.
Virulence. 2014 Jan 1;5(1):154-60. doi: 10.4161/viru.27393. Epub 2013 Dec 11.
Fast and appropriate therapy is the cornerstone in the therapy of sepsis. However, the discrimination of sepsis from non-infectious causes of inflammation may be difficult. Biomarkers have been suggested to aid physicians in this decision. There is currently no biochemical technique available which alone allows a rapid and reliable discrimination between sepsis and non-infectious inflammation. Procalcitonin (PCT) is currently the most investigated biomarker for this purpose. C-reactive protein and interleukin 6 perform inferior to PCT in most studies and their value in diagnosing sepsis is not defined. All biomarkers including PCT are also released after various non-infectious inflammatory impacts. This shortcoming needs to be taken into account when biomarkers are used to aid the physician in the diagnosis of sepsis. Polymerase chain reaction (PCR) based pathogen detection may improve time to adequate therapy but cannot rule out the presence of infection when negative.
快速和适当的治疗是脓毒症治疗的基石。然而,区分脓毒症和非感染性炎症可能具有挑战性。生物标志物被认为可以帮助医生做出这一决策。目前还没有一种生化技术可以单独快速、可靠地区分脓毒症和非感染性炎症。降钙素原(PCT)是目前研究最多的用于此目的的生物标志物。在大多数研究中,C 反应蛋白和白细胞介素 6 的表现不如 PCT,它们在诊断脓毒症中的价值尚未确定。所有的生物标志物,包括 PCT,在各种非感染性炎症反应后都会释放。在使用生物标志物帮助医生诊断脓毒症时,需要考虑到这一缺点。基于聚合酶链反应(PCR)的病原体检测可以改善治疗的及时性,但当检测结果为阴性时,不能排除感染的存在。