生物标志物对急性创伤后脓毒血症患者预后判断的研究进展
Research Progress of Biomarkers for Prognosis of Patients with Acute Post-Traumatic Sepsis
DOI: 10.12677/ACM.2024.142594, PDF,   
作者: 罗 超, 胡 毅*：新疆医科大学第五附属医院，新疆 乌鲁木齐
关键词: 脓毒血症；生物标志物；急性创伤；预后判断；Sepsis； Biomarkers； Acute Trauma； Prognosis
摘要: 急性创伤后脓毒血症是指机体创伤后继发感染病原体导致的全身炎症反应综合征，是在严重感染的基础上出现急性循环衰竭，危及生命。创伤后脓毒血症的早期诊断及对预后的评估至关重要。但由于创伤后脓毒血症缺乏特异性的临床表现及早期诊断指标，患者病情凶险且多变，其诊断和治疗是目前临床医生所面临的困惑之一。针对创伤后脓毒症，目前临床上仍缺乏特异性的用于诊断的生物标志物以及有效的治疗方法。因此，联合可靠的生物标志物以及评估生物标志物在脓毒症中的运用无疑有助于指导临床决策。本文综述了目前临床常用的生物标志物对急性创伤后脓毒血症患者治疗及预后判断的价值。
Abstract: Acute post-traumatic sepsis refers to systemic inflammatory response syndrome caused by sec-ondary infection of pathogens after trauma. Acute circulatory failure occurs on the basis of severe infection and is life-threatening. Early diagnosis and prognosis evaluation of post-traumatic sepsis are very important. However, due to the lack of specific clinical manifestations and early diagnostic indicators of post-traumatic sepsis, the patient’s condition is dangerous and changeable, and its diagnosis and treatment is one of the puzzles faced by clinicians at present. For post-traumatic sepsis, there is still a lack of specific biomarkers for diagnosis and effective treatment. Therefore, combining reliable biomarkers and evaluating the use of biomarkers in sepsis will undoubtedly help guide clinical decision making. This article reviews the value of biomarkers in the treatment and prognosis of patients with acute post-traumatic sepsis.
文章引用：罗超, 胡毅. 生物标志物对急性创伤后脓毒血症患者预后判断的研究进展[J]. 临床医学进展, 2024, 14(2): 4288-4293. https://doi.org/10.12677/ACM.2024.142594

参考文献

[1] Chiu, C. and Legrand, M. (2021) Epidemiology of Sepsis and Septic Shock. Current Opinion in Anaesthesiology, 34, 71-76. [Google Scholar] [CrossRef] 
[2] Font, M.D., Thyagarajan, B. and Khanna, A.K. (2020) Sepsis and Septic Shock—Basics of Diagnosis, Pathophysiology and Clinical Decision Making. Medical Clinics of North America, 104, 573-585. [Google Scholar] [CrossRef] [PubMed]
[3] Bracht, H., Hafner, S. and Weiß, M. (2019) [Sepsis Update: Definition and Epidemiology]. Anasthesiol Intensivmed Notfallmed Schmerzther, 54, 10-20. [Google Scholar] [CrossRef] [PubMed]
[4] Evans, T. (2018) Diagnosis and Management of Sepsis. Clinical Medi-cine Journal, 18, 146-149. [Google Scholar] [CrossRef] [PubMed]
[5] Rehn, M., Chew, M.S., Olkkola, K.T., et al. (2022) Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock in Adults 2021—Endorsement by the Scandinavian Society of Anaesthesiology and Intensive Care Medicine. Acta Anaesthesiologica Scandinavica, 66, 634-635. [Google Scholar] [CrossRef] [PubMed]
[6] Rudd, K.E., Johnson, S.C., Agesa, K.M., et al. (2020) Global, Regional, and National Sepsis Incidence and Mortality, 1990-2017: Analysis for the Global Burden of Disease Study. The Lancet, 395, 200-211. [Google Scholar] [CrossRef] 
[7] Ackerman, M.H., Ahrens, T., Kelly, J., et al. (2021) Sepsis. Critical Care Nursing Clinics of North America, 33, 407- 418. [Google Scholar] [CrossRef] [PubMed]
[8] Gunsolus, I.L., Sweeney, T.E., Liesenfeld, O., et al. (2019) Diag-nosing and Managing Sepsis by Probing the Host Response to Infection: Advances, Opportunities, and Challenges. Journal of Clinical Microbiology, 57. [Google Scholar] [CrossRef] 
[9] Pierrakos, C., Velissaris, D., Bisdorff, M., et al. (2020) Biomarkers of Sepsis: Time for A Reappraisal. Critical Care, 24, Article No. 287. [Google Scholar] [CrossRef] [PubMed]
[10] Fendl, B., Weiss, R., Eichhorn, T., et al. (2021) Extracellular Vesicles Are Associated with C-Reactive Protein in Sepsis. Scientific Reports, 11, Article No. 6996. [Google Scholar] [CrossRef] [PubMed]
[11] Stocker, M., Van Herk, W., El Heiou, S., et al. (2021) C-Reactive Protein, Procalcitonin, and White Blood Count to Rule Out Neonatal Early-Onset Sepsis within 36 Hours: A Secondary Analysis of the Neonatal Procalcitonin Intervention Study. Clinical Infectious Diseases, 73, e383-e390. [Google Scholar] [CrossRef] [PubMed]
[12] Cui, N., Zhang, H., Chen, Z., et al. (2019) Prognostic Significance of PCT and CRP Evaluation for Adult ICU Patients with Sepsis and Septic Shock: Retrospective Analysis of 59 Cases. Journal of International Medical Research, 47, 1573-1579. [Google Scholar] [CrossRef] [PubMed]
[13] Russell, C.D., Parajuli, A., Gale, H.J., et al. (2019) The Utility of Peripheral Blood Leucocyte Ratios as Biomarkers in Infectious Diseases: A Systematic Review and Meta-Analysis. Journal of Infection, 78, 339-348. [Google Scholar] [CrossRef] [PubMed]
[14] Chen, J., Li, Y. and Cui, H. (2021) Preoperative Low Hematocrit Is an Adverse Prognostic Biomarker in Ovarian Cancer. Archives of Gynecology and Obstetrics, 303, 767-775. [Google Scholar] [CrossRef] [PubMed]
[15] Hu, Z.D., Lippi, G. and Montagnana, M. (2020) Diagnostic and Prognostic Value of Red Blood Cell Distribution Width in Sepsis: A Narrative Review. Clinical Biochemistry, 77, 1-6. [Google Scholar] [CrossRef] [PubMed]
[16] Chaturvedi, R., Burton, B.N., Trivedi, S., et al. (2022) The Association of Preoperative Hematocrit with Adverse Events Following Exploratory Laparotomy in Septic Patients: A Retrospective Analysis. Journal of Intensive Care Medicine, 37, 46-51. [Google Scholar] [CrossRef] [PubMed]
[17] Totsimon, K., Biro, K., Szabo, Z.E., et al. (2017) The Relationship between Hemorheological Parameters and Mortality in Critically Ill Patients with and without Sepsis. Clinical Hemorheology and Microcirculation, 65, 119-129. [Google Scholar] [CrossRef] 
[18] Luo, M., Chen, Y., Cheng, Y., et al. (2022) Association between Hema-tocrit and the 30-Day Mortality of Patients with Sepsis: A Retrospective Analysis Based on the Large-Scale Clinical Database MIMIC-IV. PLOS ONE, 17, e265758. [Google Scholar] [CrossRef] [PubMed]
[19] Wardi, G., Brice, J., Correia, M., et al. (2020) Demystifying Lactate in the Emergency Department. Annals of Emergency Medicine, 75, 287-298. [Google Scholar] [CrossRef] [PubMed]
[20] Bakker, J., Postelnicu, R. and Mukherjee, V. (2020) Lactate: Where Are We Now? Critical Care Clinics, 36, 115-124. [Google Scholar] [CrossRef] [PubMed]
[21] Tian, X., Chen, H., Liu, H., et al. (2021) Recent Advances in Lactic Acid Production by Lactic Acid Bacteria. Applied Biochemistry and Biotechnology, 193, 4151-4171. [Google Scholar] [CrossRef] [PubMed]
[22] Fleischmann-Struzek, C. and Rudd, K. (2023) Challenges of Assessing the Burden of Sepsis. Medizinische Klinik—Intensivmedizin und Notfallmedizin, 118, 68-74. [Google Scholar] [CrossRef] [PubMed]
[23] Purcarea, A. and Sovaila, S. (2020) Sepsis, a 2020 Review for the Internist. Romanian Journal of Internal Medicine, 58, 129-137. [Google Scholar] [CrossRef] [PubMed]
[24] Einav, S., Leone, M. and Martin-Loeches, I. (2023) Sepsis and An-tibiotics: When Should We Deploy a Parachute? International Journal of Antimicrobial Agents, 61, Article ID: 106732. [Google Scholar] [CrossRef] [PubMed]
[25] Salomão, R., Ferreira, B.L., Salomão, M.C., et al. (2019) Sepsis: Evolving Concepts and Challenges. Brazilian Journal of Medical and Biological Research, 52, e8595. [Google Scholar] [CrossRef] [PubMed]
[26] Mas-Celis, F., Olea-López, J. and Parroquin-Maldonado, J.A. (2021) Sepsis in Trauma: A Deadly Complication. Archives of Medical Research, 52, 808-816. [Google Scholar] [CrossRef] [PubMed]
[27] Tan, M., Lu, Y., Jiang, H., et al. (2019) The Diagnostic Accu-racy of Procalcitonin and C-Reactive Protein for Sepsis: A Systematic Review and Meta-Analysis. Journal of Cellular Biochemistry, 120, 5852-5859. [Google Scholar] [CrossRef] [PubMed]
[28] Ozger, H.S. and Senol, E. (2022) Use of Infection Biomarkers in the Emergency Department. Turkish Journal of Emergency Medicine, 22, 169-176. [Google Scholar] [CrossRef] [PubMed]
[29] Marik, P.E. and Stephenson, E. (2020) The Ability of Procalcitonin, Lactate, White Blood Cell Count and Neutrophil-Lymphocyte Count Ratio to Predict Blood Stream Infection. Analysis of a Large Database. Journal of Critical Care, 60, 135-139. [Google Scholar] [CrossRef] [PubMed]
[30] Urrechaga, E. (2020) Reviewing the Value of Leukocytes Cell Population Data (CPD) in the Management of Sepsis. Annals of Translational Medicine, 8, Article 953. [Google Scholar] [CrossRef] [PubMed]
[31] Hernández, G., Ospina-Tascón, G.A., Damiani, L.P., et al. (2019) Effect of a Resuscitation Strategy Targeting Peripheral Perfusion Status vs Serum Lactate Levels on 28-Day Mortality among Patients with Septic Shock: The ANDROMEDA-SHOCK Randomized Clinical Trial. JAMA, 321, 654-664. [Google Scholar] [CrossRef] [PubMed]
[32] Singhal, R., Coghill, J.E., Guy, A., et al. (2005) Serum Lactate and Base Deficit as Predictors of Mortality after Ruptured Abdominal Aortic Aneurysm Repair. European Journal of Vascular and Endovascular Surgery, 30, 263-266. [Google Scholar] [CrossRef] [PubMed]
[33] Lu, Y. and Song, L. (2023) Clinical Significance of Procalcitonin, Lactic Acid, and Endotoxin Testing for Children with Severe Pneumonia and Sepsis. Alternative Therapies in Health and Medicine, 29, 218-223.
[34] Hassan, J., Khan, S., Zahra, R., et al. (2022) Role of Procalcitonin and C-Reactive Protein as Predictors of Sepsis and in Managing Sepsis in Postoperative Patients: A Systematic Review. Cureus, 14, e31067. [Google Scholar] [CrossRef] [PubMed]
[35] Jiang, M., Wu, W., Wang, X., et al. (2022) Analysis of the Predictive Effect of Lactic Acid Combined with Cardiac Troponin T and 5-Hydroxytryptophan on the Severity of Sepsis in ICU Patients and Its Correlation with Prognosis. Contrast Media & Molecular Imaging, 2022, Article ID: 6215282. [Google Scholar] [CrossRef] [PubMed]
[36] Li, Y., Wu, Y., Gao, Y., et al. (2022) Machine-Learning Based Pre-diction of Prognostic Risk Factors in Patients with Invasive Candidiasis Infection and Bacterial Bloodstream Infection: A Singled Centered Retrospective Study. BMC Infectious Diseases, 22, Article No. 150. [Google Scholar] [CrossRef] [PubMed]
[37] Papafilippou, L., Claxton, A., Dark, P., et al. (2021) Nanotools for Sepsis Diagnosis and Treatment. Advanced Healthcare Materials, 10, e2001378. [Google Scholar] [CrossRef] [PubMed]

为你推荐