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降钙素原在脓毒症精准诊疗中的多维作用及未来发展
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Abstract:
降钙素原(procalcitonin, PCT)作为脓毒症的重要生物标志物，在疾病诊断、预后评估和抗生素管理中发挥关键作用。本文综述了PCT在脓毒症中的多重应用，并探讨其局限性及未来发展方向。研究表明，PCT具有较高的敏感性和特异性，尤其在尿源性脓毒症的检测中优势明显。同时，PCT水平可用于评估患者预后，较高水平往往与不良结局相关。此外，PCT作为抗生素管理的辅助工具，有助于优化抗生素使用策略，从而减少不必要的抗生素暴露并降低死亡率。然而，PCT的应用仍受免疫抑制状态、肝肾功能损害等因素影响，需进一步研究以优化其临床使用策略。未来，PCT的应用趋势包括多标志物联合检测、人工智能驱动的精准医疗、基因组学结合分析以及新型检测技术的开发，以期提升脓毒症的早期诊断和个体化治疗水平。
Procalcitonin (PCT), as a crucial biomarker for sepsis, plays a key role in disease diagnosis, prognosis assessment, and antibiotic management. This review summarizes the multiple applications of PCT in sepsis, explores its limitations, and discusses future development trends. Studies have shown that PCT exhibits high sensitivity and specificity, particularly in the detection of urosepsis. Moreover, PCT levels are associated with patient prognosis, with elevated levels often indicating poor outcomes. Additionally, PCT serves as a valuable tool for optimizing antibiotic use, helping to reduce unnecessary antibiotic exposure and lower mortality rates. However, the clinical application of PCT is influenced by factors such as immunosuppression and impaired liver and kidney function, necessitating further research to refine its clinical utility. Future directions for PCT application include multi-biomarker integration, AI-driven precision medicine, genomic analysis, and the development of novel detection technologies, aiming to enhance early diagnosis and personalized treatment strategies for sepsis.
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