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入院时的首发体征:初始促炎标志物对ICU患者脓毒症及死亡率的预后价值

First Signs at Admission: Prognostic Value of Initial Proinflammatory Markers for Sepsis and Mortality in ICU Patients.

作者信息

Aktaş Fatma, Zer Yasemin, Elay Gülseren, Erinmez Mehmet

机构信息

Department of Medical Microbiology, Ersin Arslan Education and Research Hospital, Gaziantep 27090, Türkiye.

Department of Medical Microbiology, Faculty of Medicine, Gaziantep University, Gaziantep 27310, Türkiye.

出版信息

Pathogens. 2025 Sep 10;14(9):907. doi: 10.3390/pathogens14090907.

Abstract

Sepsis is a life-threatening condition and due to its non-specific symptoms, diagnosing sepsis and determining its severity remains difficult. Delays in recognizing sepsis can significantly increase mortality despite advances in antimicrobial therapy and resuscitation procedures. Biomarkers can help detect the presence and severity of sepsis, distinguish between types of infections, and evaluate treatment response. This prospective study aims to determine whether biomarker levels measured at the time of intensive care unit (ICU) admission can assist in the early prediction, diagnosis, and prognosis of sepsis and bacteremia. Blood samples were collected from 132 ICU patients upon admission and analyzed for CRP, IL-6, PCT, SAA, and endotoxin levels. Patients were monitored for sepsis development, blood culture results, and mortality. IL-6 levels demonstrated a significant association with prognosis and identified as an independent risk factor. CRP and PCT levels exhibit a significant effect on the development of sepsis in both univariate and multivariate analyses. Also, our study demonstrated that the presence of bacteremia in the initial blood sample taken from intensive care patients holds significant diagnostic and prognostic value even without waiting for species-level identification when combined with markers such as PCT, CRP, and IL-6.

摘要

脓毒症是一种危及生命的病症,由于其症状不具有特异性,诊断脓毒症并确定其严重程度仍然很困难。尽管抗菌治疗和复苏程序有所进展,但脓毒症识别的延迟会显著增加死亡率。生物标志物有助于检测脓毒症的存在和严重程度,区分感染类型,并评估治疗反应。这项前瞻性研究旨在确定在重症监护病房(ICU)入院时测量的生物标志物水平是否有助于脓毒症和菌血症的早期预测、诊断及预后评估。在132例ICU患者入院时采集血样,分析其CRP、IL-6、PCT、SAA和内毒素水平。对患者进行脓毒症发展、血培养结果及死亡率监测。IL-6水平与预后显著相关,并被确定为独立危险因素。在单变量和多变量分析中,CRP和PCT水平对脓毒症的发展均有显著影响。此外,我们的研究表明,即使不等待菌种鉴定,重症监护患者初始血样中的菌血症与PCT、CRP和IL-6等标志物联合时仍具有显著的诊断和预后价值。

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