[C-reactive protein and cytokines in the diagnosis of neonatal sepsis].
[C-reactive protein and cytokines in the diagnosis of neonatal sepsis].
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DOI：
10.2298/mpns0612545j
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发表时间：
2006-11-01
期刊：
影响因子：
--
通讯作者：
Martic, Jelena
中科院分区：
文献类型：
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作者：
Jankovic, Borisav;Veljkovic, Dobrila;Martic, Jelena
前言：对新生儿可能出现的败血症进行准确的评估和正确的治疗仍然是最具挑战性的临床任务。新生儿败血症的早期诊断在很大程度上是基于对不同全身炎症介质的血清浓度的测量，以及一组名为急性时相反应物的蛋白质的测量。在急性期反应物中，C-反应蛋白(CRP)是目前应用最广泛和研究最多的一种反应物。此外，我们还介绍了我们关于全身注射的最初24小时内血清CRP浓度的动态变化的原始结果，以及与抗生素的初始选择、并发症和全身注射的最终结果相关的不同的CRP动态模式。在败血症的诊断中，Interleukins和ProCALICONINS：由于CRP是新生儿败血症的特异性标志，但有些晚，因此也考虑在新生儿败血症期间使用其他炎症指标，即白介素6和8以及降钙素原。通过对初始感染刺激后激活时间的对比分析，讨论了这些早期指标的理论优势。结论：提示连续测定血清CRP水平具有诊断的准确性。作为另一种选择，建议使用更快的标记物，如降钙素原，同时测量CRP和血清水平。
INTRODUCTION: Accurate evaluation and correct treatment of neonates for possible sepsis still represent the most challenging clinical tasks. Early diagnosis of neonatal sepsis is largely based on the measurement of serum concentrations of different mediators of systemic inflammation, as well as, on a group of proteins named acute phase reactants. Among acute phase reactants, C-reactive protein (CRP) has been the most extensively used and investigated so far.SYNTHESIS AND BIOLOGICAL ROLE OF CRP: This article reviews current knowledge on the synthesis, structure and biologic roles of CRP. Also, we present our original results in regard to the kinetics of serum CRP concentration during the first 24 hours of systemic injection, as well as different patterns of CRP dynamics associated with the initial choice of antibiotics, complications and the final outcome of systemic injection.INTERLEUKINS AND PROCALCITONIN IN DIAGNOSIS OF SEPSIS: Because CRP is specific, but somewhat late marker of neonatal sepsis, possible diagnostic use of other indicators of inflammation, i.e. interleukins 6 and 8, and procalcitonin during neonatal sepsis is also considered. The theoretical advantage of these early indicators is discussed in comparative analysis of the time of their activation after initial infections stimuli.CONCLUSION: In conclusion, we point to the diagnostic accuracy of serial measurements of serum CRP levels. As an alternative, simultaneous measurement of CRP and serum levels using a faster marker, such as procalcitonin, is recommended.