新生儿败血症早期诊断生物标志物的研究进展

Advances in biomarkers for early diagnosis of neonatal sepsis

新生儿败血症是新生儿住院和死亡的主要原因,早期、准确诊断能减少经验性抗生素的使用以及抗生素滥用所带来的耐药问题,改善患儿的远期预后。血液学指标(白细胞计数等)、炎症指标(C-反应蛋白、降钙素原)等生物标志物已被用于新生儿败血症的诊断,但非确诊依据。目前新生儿败血症诊断的金标准——血培养由于所需时间较长、阳性率较低等局限性,对早期诊断的价值有限。一些非培养的技术,包括分子方法和质谱技术,可以克服培养法的一些局限性。该文对新生儿败血症早期诊断的生物标志物以及未来可能用于诊断的新方法和新技术的研究进展进行综述。

Neonatal sepsis remains a main cause of neonatal hospitalization and mortality.Prompt and accurate diagnosis can reduce the use of empirical antibiotics and the problem of drug resistance associated with antibiotic overuse,and improve the long-term prognosis of patients.Biomarkers including hematological markers(white blood cell count and so on)and inflammatory markers(C-reactive protein,procalcitonin)have been employed in diagnosing neonatal sepsis,but they are not diagnositic.The current gold standard for diagnosing neonatal sepsis,blood culture,has limited value for early diagnosis due to limitations such as the time required and the low positivity rate.Several non-culture techniques,including molecular methods and mass spectrometry,can overcome some of the limitations of culture methods.This article offers an overview of the current research on biomarkers for the early diagnosis of neonatal sepsis,as well as an examination of new methods and technologies that may be employed for diagnosis in the future.