Orfanu Alina Elena, Popescu Cristina, Leuștean Anca, Negru Anca Ruxandra, Tilişcan Cătălin, Aramă Victoria, Aramă Ștefan Sorin
National Institute for Infectious Diseases "Prof. Dr Matei Balș", Dr Calistrat Grozovici Street, no 1, 021105, Bucharest, Romania.
University of Medicine and Pharmacy "Carol Davila", Dionisie Lupu Street, no 37, 020021, Bucharest, Romania.
J Crit Care Med (Targu Mures). 2017 Aug 19;3(3):105-110. doi: 10.1515/jccm-2017-0019. eCollection 2017 Jul.
Sepsis represents a severe pathology that requires both rapid and precise positive and differential diagnosis to identify patients who need immediate antimicrobial therapy. Monitoring septic patients' outcome leads to prolonged hospitalisation and antibacterial therapy, often accompanied by substantial side effects, complications and a high mortality risk. Septic patients present with complex pathophysiological and immunological disorders and with a predominance of pro-inflammatory or anti-inflammatory mediators which are heterogeneous with respect to the infectious focus, the aetiology of sepsis or patients' immune status or comorbidities. Previous studies performed have analysed inflammatory biomarkers, but a test or combinations of tests that can quickly and precisely establish a diagnosis or prognosis of septic patients has yet to be discovered. Recent research has focused on re-analysing older accessible parameters found in the complete blood count to determine the sensitivity, specificity, positive and negative predictive values for the diagnosis and prognosis of sepsis. The neutrophil/lymphocyte count ratio (NLCR), mean platelet volume (MPV) and red blood cells distribution width (RDW) are haemogram indicators which have been evaluated and which are of proven use in septic patients' management.
脓毒症是一种严重的病理状况，需要快速且精确的阳性诊断和鉴别诊断，以识别需要立即进行抗菌治疗的患者。监测脓毒症患者的病情转归会导致住院时间延长和抗菌治疗，且常常伴有大量副作用、并发症以及高死亡风险。脓毒症患者存在复杂的病理生理和免疫紊乱，且促炎或抗炎介质占主导，这些介质在感染灶、脓毒症病因、患者免疫状态或合并症方面存在异质性。以往进行的研究分析了炎症生物标志物，但尚未发现能够快速且精确地对脓毒症患者进行诊断或预后评估的单一检测或检测组合。最近的研究集中于重新分析全血细胞计数中已有的旧参数，以确定其对脓毒症诊断和预后评估的敏感性、特异性、阳性预测值和阴性预测值。中性粒细胞/淋巴细胞计数比值（NLCR）、平均血小板体积（MPV）和红细胞分布宽度（RDW）是血液学指标，已对其进行评估且证实可用于脓毒症患者的管理。
