脓毒症的生物标志物：它们能帮助改善患者预后吗？
Biomarkers in sepsis: can they help improve patient outcome?
机构信息
4th Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, ATTIKON University Hospital.
3rd Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Sotiria Chest Hospital, Athens, Greece.
出版信息
Curr Opin Infect Dis. 2021 Apr 1;34(2):126-134. doi: 10.1097/QCO.0000000000000707.
PURPOSE OF REVIEW
Biomarkers, mainly procalcitonin, are commonly used in sepsis diagnosis, prognosis and treatment follow-up. This review summarizes the potential benefit of their use for the critically ill.
RECENT FINDINGS
Increased clinical evidence from randomized clinical trials of biomarker-guided treatment suggests a trend for appropriate but short antimicrobial treatment for the critically ill. Procalcitonin (PCT) is the most studied biomarker; in the majority of randomized clinical trials, the use of a stopping rule of antibiotics on the day when PCT is below 80% from baseline or less than 0.5 ng/ml was proven effective to reduce length of antimicrobial treatment, antibiotic-associated adverse events and infectious complications like infections by multidrug-resistant organisms and Clostridium difficile. Survival benefit was also noted.
SUMMARY
Biomarkers, mainly PCT, may help improve sepsis outcome by restriction of injudicious antimicrobial use.
目的综述
生物标志物，主要是降钙素原，常用于脓毒症的诊断、预后和治疗随访。本综述总结了其在危重病患者中的潜在应用价值。
最近的发现
来自生物标志物指导治疗的随机临床试验的更多临床证据表明，对危重病患者进行适当但短期的抗菌治疗可能是一种趋势。降钙素原（PCT）是研究最多的生物标志物；在大多数随机临床试验中，当 PCT 从基线下降 80%或低于 0.5ng/ml 时，采用抗生素停药规则被证明可以有效缩短抗菌治疗时间、减少抗生素相关不良事件以及感染多重耐药菌和艰难梭菌等感染性并发症。也注意到了生存获益。
总结
生物标志物，主要是 PCT，可能有助于通过限制不合理使用抗菌药物来改善脓毒症的预后。
Zotero 插件