聚焦腹腔内脓毒症生物标志物:文献综述。

Pub Date : 2022-12-01 DOI:10.5152/eurasianjmed.2022.22296
Rıfat Peksöz, Enes Ağırman, Fuat Şentürk, Yavuz Albayrak, Sabri Selçuk Atamanalp
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摘要

根据《第三次败血症和败血症休克国际共识定义》,败血症是指宿主对感染的反应失调导致的危及生命的器官功能障碍。由于其复杂的病理生理学和缺乏完整的治疗方法,它是一种发病率和死亡率都很高的临床病症。由于脓毒症患者占重症监护患者的很大一部分,且治疗过程漫长、费用高昂,因此对经济造成了巨大负担。因此,疾病的早期诊断和治疗至关重要。继肺炎之后,败血症的一个重要来源是腹腔内感染。由于存在多种和多微生物感染源,腹腔败血症的病情发展更为严重。腹腔内感染的有效治疗包括早期识别疾病、控制感染源、适当的抗生素治疗,以及在重症监护环境中通过出色的手术方法稳定病情。我们检索了 PubMed、EMBASE、MEDLINE 和 Cochrane 图书馆。两位作者审阅了所有确定的摘要,并挑选出文章进行全文审阅。我们纳入了评估腹腔内脓毒症介质的原始研究。急性期蛋白和趋化因子细胞因子等炎症和蛋白质介质在腹腔内败血症中起着至关重要的作用。在临床实践中,白细胞计数、C 反应蛋白和降钙素原是界定腹腔感染最常用的参数。肿瘤坏死因子-α、白细胞介素-6、高迁移率基团蛋白 B1 和前螺旋体蛋白是其他诊断效率较高的标记物,尽管它们并未被常规使用。尽管如此,我们仍然需要可用于败血症诊断和随访的高效标记物。人们对这些标记物寄予厚望。本综述旨在讨论在腹腔脓毒症诊断和随访中使用最多的标记物的重要性,以及根据目前的文献对哪些标记物进行了必要的研究。
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A Focus on Intra-Abdominal Sepsis with Biomarkers: A Literature Review.

Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection according to the Third International Consensus Definitions for Sepsis and Septic Shock definitions. It is a clinical condition with high morbidity and mortality due to its complex pathophysiology and lack of a complete treatment. It constitutes a significant economic burden because it constitutes a substantial part of intensive care patients, and the treatment process is lengthy and costly. Therefore, early diagnosis and treatment of the disease are essential. After pneumonia, an essential source of sepsis is intra-abdominal infection. Due to the presence of multiple and polymicrobial sources of infection, abdominal sepsis progresses more seriously. The effective treatment of intra-abdominal infection consists of early recognition of the disease, control of the source, appropriate antibiotic therapy, and stabilization in the intensive care setting with an excellent surgical approach. We searched PubMed, EMBASE, MEDLINE, and the Cochrane Library. Two authors reviewed all identified abstracts and selected articles for full-text review. We included original studies assessing mediators in intraabdominal sepsis. Inflammatory and protein mediators such as acute phase protein and chemokine cytokines play an essential role in intra-abdominal sepsis. In clinical practice, white blood cell count, C-reactive protein, and procalcitonin are the most used parameters in the definition of abdominal infection. Tumor necrosis factor-alpha, interleukin-6, high-mobility group protein B1, and presepsin are other markers with high diagnostic efficiency, even though they are not used routinely. Despite everything, there is a need for highly effective markers that can be used in the diagnosis and follow-up of sepsis. Great hope is attached to these markers. This review aims to discuss the importance of the most used markers in the diagnosis and follow-up of abdominal sepsis and the markers on which there are essential studies in light of current literature.

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