炎症标志物检测在重症感染病原学判断中的意义

Inflammatory response biomarkers:promising indicators for distinguishing pathogen in severe infection

重症感染及脓毒症是儿童重症监护室(PICU)患者的主要死亡原因。重症感染常起病急、进展快、累及多个器官、病原复杂多样,如何尽早明确致病病原体对治疗决策制定至关重要。依据重症患儿精准化诊断及个体化治疗策略,联合分子生物学、多组学分析技术、宏基因组测序等方法使病原学精准诊断成为可能。炎症标记物包括传统炎症因子、急性期反应蛋白、血液特异RNA生物特征谱、代谢小分子、以及免疫细胞标记物等多个维度,可从多个角度实现对病原微生物的识别。

Severe infection and sepsis are the main causes of mortality in pediatric intensive care units(PICU).Severe infection in critically illness is characterized by acute onset,rapid progression,associated with multiple organs dysfunction,and several pathogens involved.It is critical to distinguish the main pathogen as soon as possible for clinical decision-making.Up to date,precision diagnosis and individualized strategy attract more attention in the field of critical care medicine.The improvements of molecular biology,the combination of multi-omics,and metagenomics sequencing,etc may yield many new insights into precision diagnosis of etiology.Inflammatory response biomarkers are defined as conventional inflammatory factor,acute phase protein(APP),blood RNA biosignature,metabolic molecules,immune cell markers and so on,which are promising indicators for identification of pathogenic microorganisms in severe infection.