Neglected Variables in the Interpretation of Serum Procalcitonin Levels in Patients With Septic Shock
Neglected Variables in the Interpretation of Serum Procalcitonin Levels in Patients With Septic Shock
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DOI：
10.1093/infdis/jiaa204
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发表时间：
2020-08-15
影响因子：
6.4
通讯作者：
Gilbert, David N.
中科院分区：
文献类型：
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作者：
Gilbert, David N.
通过回顾激活PCT家族基因的已知刺激物，有助于解释脓毒症患者血清降钙素原（PCT）水平。在这里，我们描述了7种途径，单独或组合，可以增加血清PCT水平。作为先天免疫激活的标志物，高PCT水平影响临床诊断，可作为“源头”控制的指标，并可指导脓毒症患者抗菌治疗的持续时间。低PCT水平反映先天免疫应答几乎没有激活，影响鉴别诊断，并支持经验性抗生素治疗的中止。了解导致血清PCT水平升高的途径对于解释和后续临床管理是必要的。
The interpretation of serum procalcitonin (PCT) levels in septic patients is facilitated by reviewing the known stimuli that activate the PCT family of genes. Herein we describe 7 pathways that, alone or in combination, can increase serum PCT levels. As a marker of activation of innate immunity, high PCT levels affect clinical diagnosis, can be trended as a measure of "source" control, and can guide duration of antibacterial therapy in septic patients. Low PCT levels reflect little to no activation of an innate immune response, influence the differential diagnosis, and support the discontinuation of empiric antibiotic therapy. Understanding the pathways that result in elevated serum PCT levels is necessary for interpretation and subsequent clinical management.