一項(xiàng)檢測前降鈣素做為炎癥反應(yīng)指標(biāo)的新方法被設(shè)計(jì)用于那些面臨嚴(yán)重膿毒敗血癥危險(xiǎn)的患者的早期診斷。這項(xiàng)檢測方法已經(jīng)獲得了美國食品藥品管理局的許可。

這項(xiàng)叫做PCT LIA(luminescence immunoassay)的檢測方法是由Brahms診斷公司(Hennigsdorf, Germany; www.brahms.de)研制開發(fā)的。該公司說，對敗血癥的早期診斷與治療已經(jīng)成為重癥監(jiān)護(hù)病房每天都要面臨的挑戰(zhàn)。嚴(yán)重的膿毒敗血癥，是一種伴隨急性器官衰竭的敗血癥，是非心血管重癥監(jiān)護(hù)室的頭號(hào)死亡原因。在將來這些病例面臨著上升趨勢，特別是因?yàn)榭股氐膹V泛應(yīng)用，促進(jìn)了耐藥微生物的快速增加。盡管對重癥監(jiān)護(hù)資源的巨大投入，嚴(yán)重?cái)⊙Y的死亡率一般在28％～50％之間。

Cooper大學(xué)醫(yī)院重癥醫(yī)學(xué)主任R.Phillip Dellinger評論說：“目前已經(jīng)十分清楚，即前降鈣素的檢測為臨床醫(yī)生提供了感染與感染嚴(yán)重程度之間的顯著相關(guān)性。在經(jīng)過挑選患者中的臨床效果已經(jīng)明確，我們中心以及其它中心正在努力發(fā)現(xiàn)如何最好的應(yīng)用這種指標(biāo)，因?yàn)樗c患者的處理措施相關(guān)。在許多歐洲醫(yī)院前降鈣素PCT已經(jīng)可以得到，在美國醫(yī)生現(xiàn)在也可以得到了。

前降鈣素PCT檢測的臨床科學(xué)先鋒Konrad Reinhart教授(Jena, Germany)說：“今天，這項(xiàng)檢測在我們臨床診斷與治療敗血癥領(lǐng)域，已經(jīng)確立了檢測常規(guī)的位置，PCT在美國開始應(yīng)用將鼓勵(lì)在這個(gè)領(lǐng)域開展更多的國際臨床與科研合作。”

Inflammatory Response Marker for Sepsis

A new test for procalcitonin that serves as a marker of inflammatory response is designed for the early diagnosis of patients at risk for severe sepsis. The test has been cleared by the U.S. Food and Drug Administration (FDA).

Called PCT LIA (luminescence immunoassay), the test was developed by Brahms Diagnostics (Hennigsdorf, Germany; www.brahms.de). Early diagnosis and treatment of sepsis are daily challenges in intensive care units (ICUs), the company noted. Severe sepsis, which is sepsis with acute organ dysfunction, is the number one cause of death in noncoronary ICUs. Cases are expected to rise in the future, partly because of the widespread use of antibiotics that encourage the growth of drug-resistant microorganisms. In spite of enormous investment in critical care resources, severe sepsis mortality ranges from 28-50%.

“It is clear that elevation in procalcitonin offers the clinician a significant correlation with infection and severity of infection,” commented Dr. R. Phillip Dellinger, director of critical care medicine at Cooper University Hospital (Camden, NJ, USA). “Clinical utility in select patient populations has already been identified and our center and others continue to work to discover the optimal utilization of this marker as it relates to patient management.” Procalcitonin PCT is already available in numerous European hospitals and will now become available to doctors in the United States.

“Today, this test has established a place in our clinical routine for the diagnosis and therapy direction of sepsis,” noted Prof. Konrad Reinhart (Jena, Germany), a clinical scientific pioneer in procalcitonin PCT testing. “The availability of PCT in the United States will encourage more international clinical-scientific cooperation on this subject.”