摘要
呼吸机相关肺炎(VAP)是我国常见的医院获得性感染,发病率及死亡率高,早期诊断较为困难。肺组织活检与痰培养是目前诊断肺部感染的金标准,但因肺组织采集具有侵袭性,痰培养耗时长且假阳性率高,均导致临床应用受到限制。近年来许多研究发现部分炎性标志物水平能够在VAP的早期即出现变化,并且还能为VAP的早期治疗及预后判断提供依据。降钙素原(PCT)、可溶性髓样细胞触发受体-1(sTREM-1)、C-反应蛋白(CRP)、可溶性尿激酶型纤溶酶原激活物受体(suPAR)是目前在VAP的应用价值方面研究较多的四种炎性标志物,大部分研究认为血液PCT、sTREM-1、CRP、suPAR水平及肺泡灌洗液(BALF)PCT、sTREM-1水平在VAP的早期诊断、治疗及预后评估方面有很大价值。本文将上述四种炎性标志物在VAP中的应用价值作一综述。
Ventilator-associated pneumonia(VAP)is a common hospital acquired infection in China with high morbidity and mortality,and early diagnosis is difficult.At present,Lung tissue biopsy and sputum culture are the gold standards for the diagnosis of pulmonary infection,but the lung tissue collection is invasive,the sputum culture takes a long time and it has the high false positive rate,so the clinical application of them is limited.In recent years,many studies have found that the level of some inflammatory markers can change early in VAP and can also provide a basis for early treatment and prognosis of VAP.Procalctionin(PCT),soluble triggering receptor expressed on myloid cell-1(sTREM-1),C-reactive protein(CRP),soluble urine The soluble urokinase plasminogen receptor(suPAR)are four most important inflammatory markers in the application value of VAP currently.Most studies suggested that the level of PCT,sTREM-1,CRP,suPAR in blood and the level of PCT,sTREM-1 in bronehoalveola lavage fluid(BALF)have great value in the early diagnosis,treatment,and prognosis of VAP.This article reviews the application value of the above four inflammatory markers in VAP.
作者
李铖(综述)
刘永芳(审校)
LI Cheng;LIU Yongfang(Department of Clinical Medicine,North Sichuan Medical College,Nanchong 637000,Sichuan,China;Department of Hospital Infection Management,The Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,Sichuan,China)
出处
《西部医学》
2020年第10期1556-1560,共5页
Medical Journal of West China
基金
四川省预防医学会医院感染预防与控制研究基金资助(SCGK201807)。
