脓毒症的新生物标志物

Q4 Biochemistry, Genetics and Molecular Biology 解放军医学杂志 Pub Date : 2012-10-03 DOI:10.5772/50197
L. Xie
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引用次数: 8

摘要

重症监护室(ICU)患者脓毒症发生率较高,是患者死亡的重要原因之一,但脓毒症缺乏特定的临床表现。探索敏感、特异的感染分子标志物,准确反映感染的严重程度和预后,具有重要的临床意义。本文在我们前期研究的基础上,介绍了一些新的具有高敏感性和特异性的生物标志物,用于脓毒症的诊断和预测预后和严重程度。骨髓细胞上血清可溶性触发受体-1 (sTREM-1)表达升高提示脓毒症患者预后不良,sTREM-1位点rs2234237的改变可能是其重要机制之一。此外,尿sTREM-1可以为脓毒症患者可能的继发性急性肾损伤(AKI)提供早期预警。血清sCD163水平比降钙素原(PCT)和c反应蛋白(CRP)在脓毒症,尤其是严重脓毒症的预后中更为重要。此外,尿液sCD163在脓毒症和脓毒症相关AKI的诊断中也表现出优异的性能。miR-150、miR-297、miR-574-5p、miR -146a、miR-223、miR -15a、miR-16等循环microrna在脓毒症患者状态评估中也发挥着重要作用。在可预见的未来,包括蛋白质组学、代谢组学和反式组学在内的新兴技术可能会对发现有价值的败血症生物标志物产生深远的影响。
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New Biomarkers for Sepsis
There is a higher sepsis rate in the intensive care unit (ICU) patients, which is one of the most important causes for patient death, but the sepsis lacks specific clinical manifestations. Exploring sensitive and specific molecular markers for infection that accurately reflect infection severity and prognosis is very clinically important. In this article, based on our previous study, we introduce some new biomarkers with high sensitivity and specificity for the diagnosis and predicting the prognosis and severity of sepsis. Increase of serum soluble(s) triggering receptor expressed on myeloid cells-1 (sTREM-1) suggests a poor prognosis of septic patients, and changes of locus rs2234237 of sTREM-1 may be the one of important mechanisms. Additionally, urine sTREM-1 can provide an early warning of possible secondary acute kidney injury (AKI) in sepsis patients. Serum sCD163 level was found to be a more important factor than procalcitonin (PCT) and C-reactive protein (CRP) in prognosis of sepsis, especially severe sepsis. Moreover, urine sCD163 also shows excellent performance in the diagnosis of sepsis and sepsis-associated AKI. Circulating microRNAs, such as miR-150, miR-297, miR-574-5p, miR -146a , miR-223, miR -15a and miR-16, also play important roles in the evaluation of status of septic patients. In the foreseeable future, newly-emerging technologies, including proteomics, metabonomics and trans-omics, may exert profound effects on the discovery of valuable biomarkers for sepsis.
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解放军医学杂志
解放军医学杂志 Biochemistry, Genetics and Molecular Biology-Biochemistry, Genetics and Molecular Biology (all)
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14732
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