脓毒症心肌损伤生物标志物最新进展

Recent Advances in Biomarkers of Myocardial Damage in Sepsis

摘要: 近几年在危重症病人当中因脓毒症的发病率和死亡率逐渐上升对其早期诊断和治疗被引起越来越多的关注，早期识别感染对脓毒症心肌损伤患者的临床病程和结局至关重要。脓毒症的理想标志物应出现在病程早期，可快速、轻松地测量，具有预后意义，足够敏感，可以检测宿主反应最小的患者的感染，并且具有足够的特异性，可以区分感染与其他非感染性疾病，但既往根据患者临床表现、心脏超声心动图和部分传统标志物，对脓毒症患者心肌损伤的评估中没有呈现很好的特异度。为了能更好的早期诊断及评估病情，近期陆续出现了一些同样可能与脓毒症心肌损伤相关的新型标志物。本文主要讲述心肌损伤相关的传统与新型生物标志物优缺点与适用范围，以及生物标志物相互联合作用下对心功能状态的评估价值。

Abstract: In recent years, due to the increasing incidence and mortality of sepsis in critically ill patients, more and more attention has been paid to its early diagnosis and treatment. Early identification of infec-tion is crucial to the clinical course and outcome of patients with myocardial damage caused by sep-sis. The ideal marker for sepsis should appear early in the course of the disease, be quickly and eas-ily measured, have prognostic significance, be sensitive enough to detect infection in patients with minimal host response, and be specific enough to distinguish infection from other non- infectious diseases. There is no good specificity in the assessment of myocardial damage in patients with sep-sis. In order to have better early diagnosis and evaluation of the disease, some new markers that may also be associated with myocardial damage in sepsis have recently emerged. On the basis of traditional markers of myocardial injury, this paper mainly reviews the advantages and disad-vantages of new markers that have attracted recent attention and their application scope, and the evaluation value of recently widely cited biomarkers on cardiac function status under the interac-tion of mutual interaction.