Sepsis biomarkers a review 英文参考文献.docVIP

PierrakosandVincentCriticalCare2010,14:R15 /content/14/1/R15 RESEARCH OpenAccess Sepsisbiomarkers:areview CharalamposPierrakos,Jean-LouisVincent* Abstract Introduction:Biomarkerscanbeusefulforidentifyingorrulingoutsepsis,identifyingpatientswhomaybenefit fromspecifictherapiesorassessingtheresponsetotherapy. Methods:WeusedanelectronicsearchofthePubMeddatabaseusingthekeywords“sepsis”and“biomarker”to identifyclinicalandexperimentalstudieswhichevaluatedabiomarkerinsepsis. Results:Thesearchretrieved3370referencescovering178differentbiomarkers. Conclusions:Manybiomarkershavebeenevaluatedforuseinsepsis.Mostofthebiomarkershadbeentested clinically,primarilyasprognosticmarkersinsepsis;relativelyfewhavebeenusedfordiagnosis.Nonehassufficient specificityorsensitivitytoberoutinelyemployedinclinicalpractice.PCTandCRPhavebeenmostwidelyused, buteventhesehavelimitedabilitytodistinguishsepsisfromotherinflammatoryconditionsortopredictoutcome. Introduction C-reactive protein (CRP)hasbeenusedformanyyears Sepsisisaleadingcauseofdeathincriticallyillpatients [10,11]butitsspecificityhasbeenchallenged[12].Pro- despite theuseofmodernantibiotics andresuscitation calcitonin (PCT) has been proposed as a more specific therapies[1].Thesepticresponseisanextremelycom- [13] and better prognostic [14] marker than CRP, plex chain of events involving inflammatory and anti- although its value has also been challenged [15]. It inflammatory processes, humoralandcellular reactions remainsdifficult todifferentiate sepsisfromothernon- and circulatory abnormalities [2,3]. The diagnosis of infectious causes of systemic inflammatory response sepsis and evaluation of its severity is complicated by syndrome[16],andthereisacontinuoussearchforbet- thehighly variable andnon-specific natureofthesigns terbiomarkersofsepsis. andsymptomsofsepsis[4].However,theearlydiagno- Withthisbackgroundinmind,wereviewedthelitera- sis and stratification of the severity of sepsis is very tureonsepsisbiomarkersth