尿源性脓毒症早期诊断指标的研究进展

Research progress on early diagnositic biomarkers of urinary sepsis

Sepsis-3定义在脓毒症诊断中的价值已被广泛接受和应用。白细胞(WBC)、血小板计数、C反应蛋白(CRP)、降钙素原(PCT)和白蛋白等指标在尿源性脓毒症早期预警和诊断中应用最为广泛和方便,PCT的特异性和敏感性相对更高,WBC急剧下降对脓毒性休克具有很强的预警性,CRP的特异性相对低。IL-6、CD64、Presepsin、miRNA、PTX-3等是较新的更有价值的指标,具有更高的敏感性和特异性,但对检测技术要求较高,需要统一和规范的检测标准。多个生物标志物的组合以及与临床评分系统结合较单个生物标志物更具有临床应用价值。

The accuracy of the Sepsis-3 definition in the diagnosis of sepsis has been widely accepted and applied.Indicators such as Procalcitonin(PCT),white blood cell(WBC),C-reactive protein(CRP),platelets(PLT)and albumin are the most extensively and conveniently applied in early alert and diagnosis of urinary sepsis.PCT has a higher specificity and sensitivity compared to other biomarkers,and a sharp drop in WBC is a strong warning for septic shock.However,CRP has a relatively low specificity.IL-6,CD64,Presepsin,miRNA,and PTX-3,among others,are more valuable emerging indicators with higher sensitivity and specificity.However,uniform and standardized technology is necessary for a high quality testing.The combination of multiple biomarkers with a clinical scoring system is more useful than individual biomarkers clinically.This article mainly reviewed the progress of research on indicators related to early alert and diagnosis of urinary sepsis during recent years.