Procalcitonin in acute exacerbation of interstitial lung disease: A systematic review of current evidence

IF 2.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart & Lung Pub Date : 2025-06-06 DOI:10.1016/j.hrtlng.2025.05.014

Narat Srivali , Federica De Giacomi

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引用次数: 0

Abstract

Background

Acute exacerbation of interstitial lung disease (AE-ILD) is a severe respiratory complication with overlapping clinical features that make distinguishing it from bacterial infections challenging.

Objectives

Evaluate procalcitonin's (PCT) diagnostic performance in differentiating AE-ILD from bacterial infections, focusing on sensitivity, specificity, and clinical applications.

Methods

Systematic literature review of Medline, Embase, and Cochrane Central databases through January 2025. Included clinical trials and observational studies assessing PCT levels in patients with interstitial lung disease experiencing acute respiratory decompensation, following PRISMA guidelines.

Results

Three studies involving 122 patients demonstrated consistent PCT diagnostic performance. Sensitivity ranged from 88.9 % to 95.5 %, specificity from 77.3 % to 100 %. Receiver operating characteristic analysis showed strong discriminatory power, with areas under the curve up to 0.85. Initial evidence suggested correlations between PCT levels and bacterial culture positivity and potential prognostic implications.

Conclusions

This first systematic review reveals promising diagnostic potential of PCT in AE-ILD, though current evidence is preliminary. While PCT appears effective in differentiating bacterial infections from non-infectious exacerbations, larger multicenter studies are needed to validate these findings and address identified knowledge gaps.

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降钙素原在间质性肺疾病急性加重中的作用：对现有证据的系统回顾

背景间质性肺疾病急性加重（AE-ILD）是一种严重的呼吸系统并发症，具有重叠的临床特征，使其与细菌感染相区分具有挑战性。目的评价降钙素原（PCT）在鉴别AE-ILD与细菌感染中的诊断价值，重点关注其敏感性、特异性和临床应用。方法系统回顾Medline、Embase和Cochrane Central数据库至2025年1月的文献。纳入临床试验和观察性研究，评估间质性肺病急性呼吸失代偿患者的PCT水平，遵循PRISMA指南。结果涉及122例患者的3项研究显示了一致的PCT诊断表现。敏感性为88.9% ~ 95.5%，特异性为77.3% ~ 100%。受者工作特征分析显示出较强的判别能力，曲线下面积可达0.85。初步证据表明PCT水平与细菌培养阳性和潜在预后影响之间存在相关性。尽管目前的证据是初步的，但这一首次系统综述显示PCT在AE-ILD中的诊断潜力很大。虽然PCT在区分细菌感染和非感染性加重方面似乎有效，但需要更大规模的多中心研究来验证这些发现并解决已确定的知识空白。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Heart & Lung 医学-呼吸系统

CiteScore

4.60

自引率

3.60%

发文量

184

审稿时长

35 days

期刊介绍： Heart & Lung: The Journal of Cardiopulmonary and Acute Care, the official publication of The American Association of Heart Failure Nurses, presents original, peer-reviewed articles on techniques, advances, investigations, and observations related to the care of patients with acute and critical illness and patients with chronic cardiac or pulmonary disorders. The Journal''s acute care articles focus on the care of hospitalized patients, including those in the critical and acute care settings. Because most patients who are hospitalized in acute and critical care settings have chronic conditions, we are also interested in the chronically critically ill, the care of patients with chronic cardiopulmonary disorders, their rehabilitation, and disease prevention. The Journal''s heart failure articles focus on all aspects of the care of patients with this condition. Manuscripts that are relevant to populations across the human lifespan are welcome.