脓毒症早期诊断的生物标志物研究进展

Research progress on biomarkers for early diagnosis of sepsis

脓毒症是由感染引起的全身炎症反应综合征。脓毒症可加重发展为严重脓毒症、脓毒性休克、多器官功能障碍。由于抗菌药物的使用、液体复苏以及生命支持的发展，脓毒症的治疗水平已较过去有了明显的提高，但其病死率仍居高不下。对脓毒症早期、迅速、准确作出诊断是降低脓毒症高病死率的一项关键因素。近年来，医学界发现一些生物标志物与脓毒症早期诊断有密切关系，且有助于临床治疗。这些与脓毒症早期诊断相关的生物学标志物包括Presepsin（sCDl4-亚型）、可溶性髓样细胞触发受体-1、中性粒细胞CD64、可溶性CD163、微小RNA和肽素等。这些生物标志物的单独或联合检测为早期确诊脓毒症带来新的机遇，且有望拓宽脓毒症的治疗思路。该文就上述新兴的脓毒症早期诊断的生物标志物作一综述。

Sepsis is a complex systemic inflammatory response syndrome caused by infection. Sepsis can deteriorate to severe sepsis, septic shock, and multiple organ dysfunction syndrome. Due to the use of antimi- crobial agents, fluid resuscitation and the developments of all kinds of support life, the treatment of sepsis has greatly improved over the past years. However,the mortality rates of sepsis still remain high. Rapid,accurate and early diagnosis of sepsis is a key factor to lower the high mortality rate of sepsis. Recently, it has been found that some biomarkers are closely associated with early diagnosis of sepsis and are helpful for the treatment. These biomarkers for early diagnosis include presepsin（sCD14-subtype） ,neutrophil CD64 ,soluble triggering receptor expressed on myeloid cells-1 （ sTREM-1 ）, soluble CD163, rnicroRNAs, copeptin, and so on. Examining these biomarkers alone or in combination will bring new opportunities for the early diagnosis of sepsis, and hopefully provide new ideas for the treatment of sepsis. This article reviews the progress on the current emerging biomarkers for early diagnosis of sepsis.