Division of Critical Care Medicine, Cohen Children's Medical Center of New York, New Hyde Park, NY.
Department of Pediatrics-Cardiology.
Pediatr Rev. 2020 Apr;41(4):172-183. doi: 10.1542/pir.2018-0101.
Recent pediatric clinical research has begun to focus on risk stratification tools using multibiomarker models. C-reactive protein (CRP) and ferriti biomarkers are widely available and used to varying degrees in daily practice, but there is no single source examining the evidence behind their use.We set out to summarize the evidence behind the use of CRP and ferritin biomarkers in pediatric practice and to begin development of a consensus for their future use for pediatricians.All the literature involving CRP and ferritin in pediatrics available on PubMed was surveyed. Research applicable to daily pediatric practice was summarized in the body of the article. Pediatric clinicians of various subspecialties contributed to the summary of the use of CRP and ferritin biomarkers in clinical practice in various disease processes. A clinical decision pathway is described, and evidence is summarized.CRP and ferritin biomarkers have diverse uses with various cutoff values in the literature, making their use in daily practice difficult. Elevation of these markers coincides with their significant elevation in uncontrolled inflammation.CRP and ferritin biomarkers are widely used in pediatrics. This review provides a resource summarizing evidence into a single source. There is sufficient evidence to indicate that these biomarkers of inflammation can be useful in guiding clinical decision making in specific clinical scenarios; however, further work is needed to improve their use in clinical practice.
最近的儿科临床研究开始侧重于使用多生物标志物模型进行风险分层工具。C 反应蛋白(CRP)和铁蛋白生物标志物广泛可用,并在日常实践中不同程度地使用,但没有单一的来源来检查它们使用背后的证据。我们旨在总结 CRP 和铁蛋白生物标志物在儿科实践中的使用证据,并开始为儿科医生制定其未来使用的共识。在 PubMed 上调查了涉及儿科 CRP 和铁蛋白的所有文献。文章主体总结了适用于日常儿科实践的研究。各种儿科亚专科的临床医生对 CRP 和铁蛋白生物标志物在各种疾病过程中的临床实践中的使用进行了总结。描述了一种临床决策途径,并总结了证据。CRP 和铁蛋白生物标志物在文献中有多种用途和不同的截断值,使得它们在日常实践中的使用变得困难。这些标志物的升高与不受控制的炎症中它们的显著升高一致。CRP 和铁蛋白生物标志物在儿科中广泛使用。本综述提供了一个将证据汇总到单个来源的资源。有足够的证据表明,这些炎症标志物可用于指导特定临床情况下的临床决策;然而,需要进一步的工作来改善它们在临床实践中的使用。