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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。
Sepsis in the intensive care unit in patients with high incidence, is one of the most important cause of fatal, but the lack of specific clinical manifestations. To find specific and sensitive molecular markers that can accurately reflect the degree of sepsis infection and predict the prognosis is becoming more and more important in clinical practice. Based on the previous studies, we present some new molecular markers that are highly sensitive and specific for the diagnosis and prognosis of sepsis. Increased soluble myeloid cell-induced receptor 1 (sTREM-1) predicts poor prognosis in patients with sepsis, and one of the important mechanisms may be related to changes in rs2234237 loci. Serum sCD163 levels perform better than procalcitonin (PCT) and C-reactive protein (CRP) in predicting the prognosis of sepsis, especially severe sepsis, and urinary sTREM-1 and sCD163 may also be sepsis The diagnosis of acute kidney injury related to the disease provides valuable laboratory evidence. Circulating miRNAs such as miR-150, miR-297, miR-574-5p, miR-146a, miR-223, miR-15a and miR-16 also play an important role in the evaluation of the status of patients with sepsis. For the foreseeable future, advances in proteomics, metabonomics and cross-genomics will benefit the discovery of sepsis-related molecular biomarkers.