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这是今年儿科杂志上发表的一篇关于新生儿败血症流式检测的综述。新生儿败血症是一种症状轻微、表现无特异性、诊断困难的临床疾病，病程进展快，病死率高，因此及时诊断就显得非常重要。除了临床症状，最可靠的实验室指标是CRP和细胞因子IL-6、IL－8。本文综述了流式检测新生儿败血症的各种检测指标，尤其是CD64、HLA-DR和凋亡等指标，并阐述了各自的优点和缺点，最后总结出，CRP和IL-6、IL-8仍是最佳指标，CD64可作为补充指标使敏感度增加至100％。
各项指标特异度和敏感度
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Int J Pediatr. 2013;2013:763191. doi: 10.1155/2013/763191. Epub 2013 Feb 3.
Flow cytometry in the detection of neonatal sepsis.
Umlauf VN , Dreschers S , Orlikowsky TW .
Source
Department of Neonatology, Children's Hospital, University Hospital of RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.
Abstract
Neonatal sepsis remains a burden problem by showing minimal initial symptoms of subtle character, nonspecific manifestation, and diagnostic pitfalls. The clinical course can be fulminant and fatal if treatment is not commenced promptly. It is therefore crucial to establish early diagnosis and initiate adequate therapy. Besides clinical symptoms, the most reliable laboratory markers in establishing diagnosis is currently the combined measurement of CRP and a cytokine (IL-6 and IL-8). Due to their different kinetics, a diagnostic gap might occur and thus withholding antimicrobial therapy in clinical suspicion of infection is not acceptable. We therefore need parameters which unerringly differentiate between infants in need for antimicrobial therapy and those who are not. Flow cytometry promises to be a useful tool in this field, allowing the determination of different cellular, dissolved, and functional pathophysiological components of sepsis. Despite technical and methodical advances in flow cytometry, its use in clinical routine is still limited. Advantages and disadvantages of promising new parameters in diagnosis of sepsis performed by flow cytometry, particularly CD64, HLA-DR, and apoptosis, are reviewed here. The necessity of tests to be used as an "ideal" parameter is presented.
PMID: 23431318
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发表于 2013-2-24 15:22:08
发表于 2014-1-19 21:05:08
