Department of Internal medicine, Amager Hospital, Italiensvej 1, 2300 Copenhagen, Denmark.
Department of Day Surgery, Hvidovre Hospital, Kettegaards Alle 30, 2650 Hvidovre, Denmark.
Eur J Intern Med. 2017 Nov;45:46-50. doi: 10.1016/j.ejim.2017.09.030. Epub 2017 Sep 29.
Sepsis is a prevalent condition among hospitalized patients that carries a high risk of morbidity and mortality. Rapid recognition of sepsis as the cause of deterioration is desirable, so effective treatment can be initiated rapidly. Traditionally, diagnosis was based on presence of two or more positive SIRS criteria due to infection. However, recently published sepsis-3 criteria put more emphasis on organ dysfunction caused by infection in the definition of sepsis. Regardless of this, no gold standard for diagnosis exist, and clinicians still rely on a number of traditional and novel biomarkers to discriminate between patients with and without infection, as the cause of deterioration.
Narrative review of current literature.
A number of the most promising biomarkers for diagnoses and prognostication of sepsis are presented.
Procalcitonin, presepsin, CD64, suPAR, and sTREM-1 are the best evaluated biomarkers for diagnosis and prognostication of sepsis to date. All have limitations in differentiation between infected and non-infected patients with SIRS, and their future role in diagnosis needs to be evaluated. It is important to test utility, performance, and validity of future biomarkers before implementing them in routine clinical care.
脓毒症是住院患者中常见的病症，具有很高的发病率和死亡率。快速识别脓毒症是病情恶化的原因是理想的，以便能够迅速开始有效的治疗。传统上，诊断基于感染引起的两个或更多阳性 SIRS 标准。然而，最近发布的脓毒症-3 标准在脓毒症的定义中更强调感染引起的器官功能障碍。尽管如此，由于目前仍缺乏金标准诊断，临床医生仍然依赖于许多传统和新型生物标志物来区分感染和非感染患者，以及病情恶化的原因。
对当前文献进行叙述性综述。
提出了一些用于脓毒症诊断和预后的最有前途的生物标志物。
降钙素原、前降钙素原、CD64、suPAR 和 sTREM-1 是迄今为止用于脓毒症诊断和预后评估的最有评估价值的生物标志物。所有这些标志物在区分 SIRS 感染和非感染患者方面都存在局限性，它们在诊断中的未来作用需要进一步评估。在将未来的生物标志物纳入常规临床护理之前，测试其效用、性能和有效性非常重要。
