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[降钙素原在重症监护病房中的鉴别诊断及鉴别治疗可能性]

[Procalcitonin in the intensive care unit : Differential diagnostic and differential therapeutic possibilities].

作者信息

Großmann S, Schroll S, Pfeifer M

机构信息

Klinik für Pneumologie und konservative Intensivmedizin, Krankenhaus Barmherzige Brüder Regensburg, Prüfeninger Str. 86, 93049, Regensburg, Deutschland.

出版信息

Med Klin Intensivmed Notfmed. 2021 Oct;116(7):561-569. doi: 10.1007/s00063-020-00703-1. Epub 2020 Jun 29.

Abstract

Procalcitonin (PCT) is formed in IL6-mediated, IL8-mediated, and TNFα-mediated systemic inflammation conditions, in multiple organs and structures of the body. In patients with sepsis, significantly increased PCT levels are found. The PCT levels are highly correlated with the severity of the illness, and decreased PCT levels under therapy correlates with a better prognosis. In the differential diagnosis, measuring the PCT level helps differentiate between bacterial and viral infections. Noninfectious inflammatory reactions can, however, show moderately increased PCT levels. Cut-off values depend on renal and hepatic function. A therapeutic algorithm using PCT levels could be used for determining duration of a course of antibiotics, which can reduce antibiotic usage. In this paper, the differential diagnostic and differential therapeutic possibilities of PCT levels for critically ill patients are discussed.

摘要

降钙素原(PCT)在IL6介导、IL8介导和TNFα介导的全身炎症状态下,于身体的多个器官和组织中形成。在脓毒症患者中,可发现PCT水平显著升高。PCT水平与疾病严重程度高度相关,治疗过程中PCT水平下降与较好的预后相关。在鉴别诊断中,检测PCT水平有助于区分细菌感染和病毒感染。然而,非感染性炎症反应可表现为PCT水平中度升高。临界值取决于肾功能和肝功能。利用PCT水平的治疗算法可用于确定抗生素疗程的时长,这可减少抗生素的使用。本文讨论了PCT水平在危重症患者中的鉴别诊断及鉴别治疗可能性。

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