新型生物标志物在脓毒症诊断、治疗和预后中的潜在价值*

Potential value of new biomarkers in diagnosis, treatment and prognosis of sepsis*

摘要:

生物标志物在脓毒症的早期诊断、指导治疗和判断预后方面具有很大的作用。病原学检查是脓毒症病因诊断的金标准，但多数情况下需要一定时间才能得到结果，且有时阳性率不高，难以早期和准确地进行诊断。C反应蛋白（CRP）、降钙素原（PCT）等经典生物标志物已广泛应用于临床，对脓毒症的鉴别诊断和指导治疗有重要的临床价值，但这些经典的生物标志物，在非感染疾病中同样可以升高，从而影响诊断和治疗。本文对近年研究发现的一些新型生物标志物，如可溶性髓样细胞触发受体-1（sTREM-1）、Presepsin（sCD14-T）、可溶性尿激酶型纤溶酶原激活物受体（suPAR）等，在脓毒症诊断、治疗和预后中的作用进行归纳总结，寻找其在脓毒症诊治中的应用价值和意义。

Abstract:

Biomarkers have great potential in improving the diagnosis, prognosis and treatment of sepsis. Etiologocal examination is the gold standard’ for the diagnosis of sepsis, but it takes a certain time to get the results in most cases, and sometiomes the positive rate is not high. Therefore, it is difficult to make early and accurate diagnosis. Classical biomarkers such as CRP and PCT have been widely used in clinical practice, and have shown important clinical value for the diagnosis, antidiastole and guiding treatment of sepsis. But these classical inflammatory markers can also be elevated in non-infectious diseases, thus affecting diagnosis and treatment. In this paper, some new biomarkers discovered in recent years, such as sTREM-1, sCD14-T, suPAR and so on, are summarized in the diagnosis, treatment and prognosis of pus study, in order to find out their value and significance in the diagnosis and treatment of sepsis.