降钙素原--败血症的标志物

Sanaul Hoque, Suzauddin Talukder, Md. Masuduz zaman, Shahed-Ul- Matin, Ruhul Amin Khan, Mst. Zinat Amin, A. H. M. Anisuzzaman
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引用次数: 0

摘要

背景:败血症仍然是一个重大的健康问题,尤其是在孟加拉国这样资源有限的地区。尽管有可用的诊断方法,但确定败血症患者的细菌感染仍具有挑战性,这促使人们探索生物标记物。降钙素原(PCT)已成为治疗败血症等血流感染的一种有前途的生物标记物。研究目的本研究旨在评估测量血清 Procalcitonin 水平在诊断和评估败血症严重程度方面的效用,重点是加强重症监护病房(ICU)的早期治疗。研究方法对 2015 年 4 月至 9 月期间达卡联合军事医院重症监护室收治的 50 名有败血症临床表现的患者进行了前瞻性研究。研究对象包括所有年龄和性别的患者,但不包括近期有大手术、外伤或烧伤病史的患者。对患者进行了详细的临床评估和实验室检查,并将数据记录在标准化的表格中。结果在接受评估的 50 名患者中,64% 为男性,36% 为女性,平均年龄为(56.11±10.89)岁。脓毒症在年龄大于 50 岁的患者(60%)和男性(64%)中发病率较高。呼吸道感染(RTI)是败血症最常见的病因(占病例的 40%),肺炎克雷伯菌是主要病原菌。较高的序贯器官衰竭评估(SOFA)评分与血清 PCT 浓度的升高显著相关。血清 PCT 在非败血症组和败血症组之间存在显著差异(P 值<0.001),敏感性和特异性分别为 91% 和 83.3%。结论血清 PCT 是危重病人败血症的一种有前途的标记物,可提高诊断的确定性并为患者管理提供信息。将其纳入常规检查可改善重症监护病房的治疗效果和患者护理。
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Procalcitonin-A Marker of Sepsis
Background: Sepsis remains a significant health concern, particularly in resource-limited regions like Bangladesh. Despite available diagnostic methods, identifying bacterial infections in septic patients proves challenging, prompting the exploration of biomarkers. Procalcitonin (PCT) has emerged as a promising biomarker for bloodstream infections like sepsis. Objective: This study aims to evaluate the utility of measuring serum PCT levels in diagnosing and assessing the severity of sepsis, with a focus on enhancing early treatment in intensive care units (ICUs). Method: A prospective study was conducted on 50 patients admitted to the Combined Military Hospital, Dhaka ICU, exhibiting clinical manifestations of sepsis between April and September 2015. Patients of all ages and genders were included, while those with recent major surgery, trauma, or burn history were excluded. Detailed clinical assessments and laboratory investigations were performed, with data recorded on a standardized proforma. Result: Of the 50 patients evaluated, 64% were male, and 36% were female, with a mean age of 56.11±10.89 years. Sepsis was more prevalent in patients aged >50 years (60%) and in males (64%). Respiratory tract infection (RTI) was the most common source of sepsis (40% of cases), with Klebsiella pneumonia being the predominant organism. Higher Sequential Organ Failure Assessment (SOFA) scores correlated significantly with elevated serum PCT concentrations. Serum PCT demonstrated a significant difference between non-septic and septic groups (p-value <0.001), exhibiting sensitivity and specificity of 91% and 83.3%, respectively. Conclusion: Serum PCT emerges as a promising marker for sepsis in critically ill patients, enhancing diagnostic certainty and informing patient management. Its addition to routine work-ups could improve outcomes and patient care in ICUs.
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