败血症性心肌病生物标志物研究进展

Q3 Medicine
Hongbin Li, Bei Hu
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引用次数: 0

摘要

脓毒症是全球死亡的主要原因之一,脓毒症引起的心肌病(SIC)患者的死亡率激增50%以上。早期识别脓毒症,特别是SIC患者,并实施临床干预是降低死亡率的重要措施。近年来,用于SIC诊断和预后的生物标志物迅速涌现。在经典的心肌损伤生物标志物中,心肌肌钙蛋白(cTn)、脑利钠肽(BNP)、可溶性生长刺激基因2蛋白(sST2)对SIC的预后具有预测价值。同时,心脏型脂肪酸结合蛋白(h-FABP)具有较高的诊断价值。此外,血浆代谢物、microRNA (miRNA)以及最近发现的与败血症或心血管疾病相关的标志物在SIC的诊断和预后方面也显示出突出的预测价值。例如,外泌体miR-150-5p、血miR-155、血miR-378a-3p、血miR-21-3p、血miR-233、血miR-23b、血miR-135、脂载素(LCN)、血红素加氧酶-1 (HO-1)、成纤维细胞生长因子-21 (FGF-21)、生长分化因子-15 (GDF-15)在诊断SIC时显示出不同程度的预测价值。S100A8/A9蛋白、甘油三酯-葡萄糖(TyG)指数、血管紧张素原II (Ang II)、乳铁蛋白与SIC预后相关。同时,已经发现多种生物标志物的组合优于单一生物标志物,某些组合表现出更好的诊断性能。然而,这些研究大多采用单中心临床数据,有一定的局限性,仍需要更多高质量的证据支持。因此,寻找有高质量证据支持、具有床边应用潜力、具有高灵敏度和特异性的生物标志物组合,对于SIC的预防、诊断和治疗至关重要。本文对目前报道的具有预测价值的生物标志物以及多种生物标志物联合诊断预测的文章进行综述,以期不断优化早期SIC特异性识别的诊断策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Research progress on the biomarkers of sepsis-induced cardiomyopathy].

Sepsis constitutes one of the principal causes of death globally, and the mortality rate of patients complicated with sepsis-induced cardiomyopathy (SIC) surges by over 50%. Early identification of patients with sepsis, particularly SIC, and implementing clinical intervention are vital measures to reduce the mortality. In recent years, biomarkers for the diagnosis and prognosis of SIC have emerged rapidly. Among classical myocardial injury biomarkers, cardiac troponin (cTn), brain natriuretic peptide (BNP), and soluble growth stimulation gene 2 protein (sST2) have predictive value for the prognosis of SIC. Meanwhile, heart-type fatty acid-binding protein (h-FABP) possess relatively high value in diagnosis. Moreover, plasma metabolites, microRNA (miRNA), as well as recently identified markers related to sepsis or cardiovascular diseases also demonstrate outstanding predictive value in both the diagnosis and prognosis of SIC. For instance, exosomal miR-150-5p, blood miR-155, blood miR-378a-3p, blood miR-21-3p, blood miR-233, blood miR-23b, blood miR-135, lipocalin (LCN), heme oxygenase-1 (HO-1), fibroblast growth factor-21 (FGF-21), and growth differentiation factor-15 (GDF-15) show varying degrees of predictive value when it comes to diagnosing SIC. S100A8/A9 protein, triglyceride-glucose (TyG) index, angiotensinogen II (Ang II) and lactoferrin are correlated with the prognosis of SIC. Meanwhile, it has been discovered that the combination of multiple biomarkers outperforms a single biomarker, and certain combinations exhibit superior diagnostic performance. However, most of these studies use single-center clinical data, which has certain limitations and still calls for more high-quality evidence support. Therefore, identifying biomarker combinations that are supported by high-quality evidence, have bedside application potential, and possess high sensitivity and specificity is of crucial importance for the prevention, diagnosis, and treatment of SIC. This review is carried out on the current articles that report biomarkers with predictive value and the diagnosis and prediction of multiple biomarkers in combination, in the hope of continuously optimizing the diagnostic strategy for the specific identification of early SIC.

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来源期刊
Zhonghua wei zhong bing ji jiu yi xue
Zhonghua wei zhong bing ji jiu yi xue Medicine-Critical Care and Intensive Care Medicine
CiteScore
1.00
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