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降钙素原:一种用于脓毒症和抗生素治疗的有前景的诊断标志物。

Procalcitonin: a promising diagnostic marker for sepsis and antibiotic therapy.

作者信息

Vijayan Ashitha L, Ravindran Shilpa, Saikant R, Lakshmi S, Kartik R, G Manoj

机构信息

Diagnostic Products Division, Corporate R&D Centre, HLL Lifecare Limited, Akkulam, Sreekariyam (P.O), Trivandrum, Kerala India.

出版信息

J Intensive Care. 2017 Aug 3;5:51. doi: 10.1186/s40560-017-0246-8. eCollection 2017.

Abstract

BACKGROUND

Sepsis is a global healthcare problem, characterized by whole body inflammation in response to microbial infection, which leads to organ dysfunction. It is becoming a frequent complication in hospitalized patients. Early and differential diagnosis of sepsis is needed critically to avoid unnecessary usage of antimicrobial agents and for proper antibiotic treatments through the screening of biomarkers that sustains with diagnostic significance.

MAIN BODY OF ABSTRACT

Current targeting conventional markers (C-reactive protein, white blood cell, tumour necrosis factor-α, interleukins, etc.) are non-specific for diagnosing sepsis. Procalcitonin (PCT), a member of the calcitonin super family could be a critical tool for the diagnosis of sepsis. But to distinguish between bacterial versus viral infections, procalcitonin alone may not be effective. Rapid elevation in the concentration of procalcitonin and other newly emerging biomarkers during an infection and its correlation with severity of illness makes it an ideal biomarker for bacterial infection. Beside this, the procalcitonin levels can be used for monitoring response to antimicrobial therapy, diagnosis of secondary inflammations, diagnosis of renal involvement in paediatric urinary tract infection, etc. The present article summarizes the relevance of procalcitonin in the diagnosis of sepsis and how it can be useful in determining the therapeutic approaches.

CONCLUSION

Further studies are needed to better understand the application of PCT in the diagnosis of sepsis, differentiating between microbial and non-microbial infection cases and determining the therapeutic approaches for sepsis.

摘要

背景

脓毒症是一个全球性的医疗问题,其特征是机体对微生物感染产生全身炎症反应,进而导致器官功能障碍。它正成为住院患者中常见的并发症。为避免不必要地使用抗菌药物以及通过筛选具有诊断意义的生物标志物来进行恰当的抗生素治疗,对脓毒症进行早期和鉴别诊断至关重要。

摘要主体

目前用于诊断脓毒症的传统标志物(如C反应蛋白、白细胞、肿瘤坏死因子-α、白细胞介素等)缺乏特异性。降钙素原(PCT)作为降钙素超家族的一员,可能是诊断脓毒症的关键工具。但仅靠降钙素原可能无法有效区分细菌感染与病毒感染。感染期间降钙素原及其他新出现的生物标志物浓度迅速升高,且与疾病严重程度相关,这使其成为细菌感染的理想生物标志物。除此之外,降钙素原水平可用于监测对抗菌治疗的反应、诊断继发性炎症、诊断小儿尿路感染中的肾脏受累情况等。本文总结了降钙素原在脓毒症诊断中的相关性以及它在确定治疗方法方面的作用。

结论

需要进一步研究以更好地理解降钙素原在脓毒症诊断中的应用,区分微生物感染和非微生物感染病例,并确定脓毒症的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb3e/5543591/08e88f7578ee/40560_2017_246_Fig1_HTML.jpg

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