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脓毒症的生物标志物:重新评估的时候到了。

Biomarkers of sepsis: time for a reappraisal.

机构信息

Intensive Care Department, Brugmann University Hospital, Université Libre de Bruxelles, Brussels, Belgium.

Internal Medicine Department, University Hospital of Patras, Patras, Greece.

出版信息

Crit Care. 2020 Jun 5;24(1):287. doi: 10.1186/s13054-020-02993-5.


DOI:10.1186/s13054-020-02993-5
PMID:32503670
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7273821/
Abstract

INTRODUCTION: Sepsis biomarkers can have important diagnostic, therapeutic, and prognostic functions. In a previous review, we identified 3370 references reporting on 178 different biomarkers related to sepsis. In the present review, we evaluate the progress in the research of sepsis biomarkers. METHODS: Using the same methodology as in our previous review, we searched the PubMed database from 2009 until September 2019 using the terms "Biomarker" AND "Sepsis." There were no restrictions by age or language, and all studies, clinical and experimental, were included. RESULTS: We retrieved a total of 5367 new references since our previous review. We identified 258 biomarkers, 80 of which were new compared to our previous list. The majority of biomarkers have been evaluated in fewer than 5 studies, with 81 (31%) being assessed in just a single study. Apart from studies of C-reactive protein (CRP) or procalcitonin (PCT), only 26 biomarkers have been assessed in clinical studies with more than 300 participants. Forty biomarkers have been compared to PCT and/or CRP for their diagnostic value; 9 were shown to have a better diagnostic value for sepsis than either or both of these biomarkers. Forty-four biomarkers have been evaluated for a role in answering a specific clinical question rather than for their general diagnostic or prognostic properties in sepsis. CONCLUSIONS: The number of biomarkers being identified is still increasing although at a slower rate than in the past. Most of the biomarkers have not been well-studied; in particular, the clinical role of these biomarkers needs to be better evaluated.

摘要

简介:脓毒症生物标志物具有重要的诊断、治疗和预后作用。在之前的综述中,我们确定了 3370 篇报告了与脓毒症相关的 178 种不同生物标志物的参考文献。在本综述中,我们评估了脓毒症生物标志物研究的进展。

方法:我们使用与之前综述相同的方法,在 PubMed 数据库中搜索了 2009 年至 2019 年 9 月期间使用“生物标志物”和“脓毒症”这两个术语的文献,没有年龄或语言的限制,所有临床和实验研究都被纳入。

结果:自上次综述以来,我们共检索到 5367 篇新文献。我们确定了 258 种生物标志物,其中 80 种是我们之前列表中没有的。大多数生物标志物的评估研究少于 5 项,其中 81 项(31%)仅评估了一项研究。除了 C 反应蛋白(CRP)或降钙素原(PCT)的研究外,只有 26 种生物标志物在超过 300 名参与者的临床研究中进行了评估。40 种生物标志物已被用于比较 PCT 和/或 CRP 的诊断价值;有 9 种生物标志物在诊断脓毒症方面比 PCT 和/或 CRP 更有价值。44 种生物标志物已被评估用于回答特定的临床问题,而不是用于评估其在脓毒症中的一般诊断或预后特性。

结论:尽管目前的增长速度比过去慢,但被识别的生物标志物数量仍在增加。大多数生物标志物尚未得到充分研究;特别是,这些生物标志物的临床作用需要更好地评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b27d/7275366/80786190f1d5/13054_2020_2993_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b27d/7275366/80786190f1d5/13054_2020_2993_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b27d/7275366/80786190f1d5/13054_2020_2993_Fig1_HTML.jpg

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[8]
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本文引用的文献

[1]
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Crit Care. 2019-2-8

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Utility of neutrophil CD64 and serum TREM-1 in distinguishing bacterial infection from disease flare in SLE and ANCA-associated vasculitis.

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J Am Coll Surg. 2018-9-21

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