Division of Infectious Diseases , Fraser Health Authority ; Department of Medicine , Abbotsford Regional Hospital and Cancer Center , Abbotsford, British Columbia ; Clinical Assistant Professor , University of British Columbia , Canada.
Open Forum Infect Dis. 2015 Jul 3;2(3):ofv098. doi: 10.1093/ofid/ofv098. eCollection 2015 Sep.
Acute-phase reactants such as erythrocyte sedimentation rate and C-reactive protein have traditionally been used as markers for inflammation and as a measure of "sickness index" in infectious and noninfectious conditions. In the last decade, more data have become available on the wider and more specific role for these markers in the management of complex infections. This includes the potential role in early diagnosis, in differentiating infectious from noninfectious causes, as a prognostic marker, and in antibiotic guidance strategies. A better defined role for biological markers as a supplement to clinical assessment may lead to more judicious antibiotic prescriptions, and it has the potential for a long-term favorable impact on antimicrobial stewardship and antibiotic resistance. Procalcitonin as a biological marker has been of particular interest in this regard. This review examines the current published evidence and summarizes the role of various acute-phase markers in infections. A MEDLINE search of English-language articles on acute-phase reactants and infections published between 1986 and March 2015 was conducted. Additional articles were also identified through a search of references from the retrieved articles, published guidelines, systematic reviews, and meta-analyses.
急性反应物质，如红细胞沉降率和 C 反应蛋白，传统上一直被用作炎症的标志物，并作为传染性和非传染性疾病的“疾病指数”的衡量标准。在过去的十年中，关于这些标志物在复杂感染的治疗中更广泛和更具体的作用，有了更多的数据。这包括在早期诊断、区分感染性和非感染性病因、作为预后标志物以及抗生素指导策略方面的潜在作用。生物标志物作为临床评估的补充的作用更为明确，可能会导致更明智地使用抗生素，并且有可能对抗菌药物管理和抗生素耐药性产生长期的有利影响。降钙素原作为一种生物标志物，在这方面尤其受到关注。本文回顾了目前已发表的证据，并总结了各种急性反应物质标志物在感染中的作用。对 1986 年至 2015 年 3 月期间发表的关于急性反应物和感染的英文文章进行了 MEDLINE 检索。还通过检索已检索文章、出版指南、系统评价和荟萃分析的参考文献来确定其他文章。
