脓毒症:新兴生物学分子标志物初探(英文)  

New biomarkers for sepsis

作　　者：解立新 

机构地区：[1]Department of Respiratory Medicine,Hainan Branch of General Hospital of Chinese PLA,Sanya,Hainan 572000,China

出　　处：《解放军医学杂志》2013年第1期6-9,共4页Medical Journal of Chinese People's Liberation Army

摘　　要：脓毒症在重症监护室患者中的发病率高,是最重要的致死性病因之一,但缺乏特异性的临床表现。探寻能准确反映脓毒症感染程度并预测预后的特异、敏感的分子标志物,在临床工作中日趋重要。在既往研究的基础上,本文介绍了一些新的对脓毒症诊断、预后判断具有高度敏感性和特异性的分子标志物。可溶性髓样细胞诱发受体1(sTREM-1)的增加预示脓毒症患者的不良预后,而其中重要机制之一可能与rs2234237位点改变相关。血清sCD163水平在脓毒症,尤其是重症脓毒症的预后预测中,较降钙素原(PCT)和C反应蛋白(CRP)表现更为出色,尿sTREM-1和sCD163还可为脓毒症相关急性肾损伤的诊断提供有价值的实验室依据。循环miRNAs(如miR-150、miR-297、miR-574-5p、miR-146a、miR-223、miR-15a、miR-16)也在脓毒症患者的状态评价中发挥着重要作用。在可预见的未来,蛋白质组学、代谢组学和跨组学这些新兴技术的发展将对脓毒症相关分子生物学标志物的发现历程有所裨益。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.

关 键 词：脓毒症 生物学标记 髓样细胞诱发受体1 抗原 CD163 微RNAS 

分 类 号：R631[医药卫生—外科学]