Link Fabian, Krohn Knut, Burgdorff Anna-Maria, Christel Annett, Schumann Julia
Clinic for Anesthesiology and Surgical Intensive Care, University Hospital Halle (Saale), 06120 Halle, Germany.
Core Unit DNA Technologies, Medical Faculty, Leipzig University, 04103 Leipzig, Germany.
Diagnostics (Basel). 2020 Sep 16;10(9):701. doi: 10.3390/diagnostics10090701.
Sepsis represents a serious medical problem accounting for numerous deaths of critically ill patients in intensive care units (ICUs). An early, sensitive, and specific diagnosis is considered a key element for improving the outcome of sepsis patients. In addition to classical laboratory markers, ICU scoring systems and serum miRNAs are discussed as potential sepsis biomarkers. In the present prospective observational study, the suitability of miRNAs in sepsis diagnosis was tested based on proper validated and normalized data (i.e., absolute quantification by means of Droplet Digital PCR (ddPCR)) in direct comparison to classical sepsis markers and ICU scores within the same patient cohort. Therefore, blood samples of septic intensive care patients ( = 12) taken at day of admission at ICU were compared to non-septic intensive care patients ( = 12) and a healthy control group ( = 12). Our analysis indicates that all tested biomarkers have only a moderate informative power and do not allow an unequivocal differentiation between septic and non-septic ICU patients. In conclusion, there is no standalone laboratory parameter that enables a reliable diagnosis of sepsis. miRNAs are not superior to classical parameters in this respect. It seems recommendable to measure multiple parameters and scores and to interpret them with regard to the clinical presentation.
脓毒症是一个严重的医学问题，导致重症监护病房（ICU）中众多重症患者死亡。早期、灵敏且特异的诊断被认为是改善脓毒症患者预后的关键因素。除了传统的实验室指标外，ICU评分系统和血清微小RNA（miRNA）也被作为潜在的脓毒症生物标志物进行讨论。在本前瞻性观察研究中，基于经过适当验证和标准化的数据（即通过液滴数字PCR（ddPCR）进行绝对定量），对miRNA在脓毒症诊断中的适用性进行了测试，并与同一患者队列中的传统脓毒症标志物和ICU评分进行直接比较。因此，将入住ICU当天采集的脓毒症重症监护患者（n = 12）的血样与非脓毒症重症监护患者（n = 12）和健康对照组（n = 12）进行比较。我们的分析表明，所有测试的生物标志物的信息价值都仅为中等，无法明确区分脓毒症和非脓毒症ICU患者。总之，没有单一的实验室参数能够可靠地诊断脓毒症。在这方面，miRNA并不优于传统参数。测量多个参数和评分并结合临床表现进行解读似乎是可取的。
