Assessment on Biomarkers for Differential Diagnosis between Infectious and Non-infectious Pulmonary Diseases_Chinese Journal of Respiratory and Critical Care Medicine

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QU Jieming , Hanssa Summah

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Keywords：

血清生物标志物; 肺部感染

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对临床上一个拟诊肺部感染的患者, 临床医生通常依据症状、白细胞总数和分类计数, 以及胸部影像学检查作出诊断, 以期尽早开始治疗, 此时抗生素的选择只能是经验性的, 等治疗后随访观察胸片上的浸润影有无吸收才能确定此浸润影是否为感染性的。换言之, 临床症状及影像学检查对于鉴别感染性和非感染性肺部疾病缺乏特异性, 而肺部感染的诊断多属于回顾性的。
目前, 有一些生物标志物用于帮助判断肺部浸润影为感染性或非感染性, 主要包括C 反应蛋白( C-reactive protein,CRP) 、降钙素原( procalcitonin, PCT) 和可溶性髓样细胞触发受体1( soluble triggering receptor expressed onmyeloid cells-1,sTREM-1) 等。

Citation： QU Jieming,Hanssa Summah. Assessment on Biomarkers for Differential Diagnosis between Infectious and Non-infectious Pulmonary Diseases. Chinese Journal of Respiratory and Critical Care Medicine, 2009, 09(6): 517-518. doi: Copy

1.	Flanders SA, Stein J, Shochat G, et al. Performance of a bedside C-reactive protein test in the diagnosis of community-acquired pneumonia in adults with acute cough. Am J Med, 2004, 116: 529- 535.
2.	Almirall J, Bol í bar I, Toran P, et al. Contribution of C-reactive protein to the diagnosis and assessment of severity of communityacquired pneumonia. Chest, 2004, 125: 1192-1195.
3.	Smith RP, Lipworth BJ. C-reactive protein in simple communityacquired pneumonia. Chest, 1995, 107: 1028-1031.
4.	Offidani M, Corvatta L, Malerba L, et al. Diagnostic value of Creactive protein in discriminating fungal from nonfungal pulmonary infiltrates in patients with hematologic malignancies. Support Care Cancer, 2006, 14: 874-877.
5.	P ó voa P, Coelho L, Almeida E, et al. C-reactive protein as a marker of infection in critically ill patients. Clin Microbiol Infect,2005, 11: 101-108.
6.	Chan YL, Tseng CP, Tsay PK, et al. Procalcitonin as a marker of bacterial infection in the emergency department: an observational study. Crit Care, 2004, 8: R12-R20.
7.	Pelosi P, Barassi A, Severgnini P, et al. Prognostic role of clinical and laboratory criteria to identify early ventilator-associated pneumonia in brain injury. Chest, 2008, 134: 101-108.
8.	Gendrel D, Raymon J, Moulin F, et al. Procalcitonin in community-acquired pneumonia: comparison with interleukin-6, Creactive protein, and interferon-alpha for diagnosis of bacterial vs.viral infections in children. Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother, 1999 , 39 :237.
9.	Masi á M, Guti é rrez F, Shum C, et al. Usefulness of procalcitonin levels in community-acquired pneumonia according to the patients outcome research teampneumonia severity index. Chest, 2005, 128 :2223-2229.
10.	Shehabi Y, Seppelt I. Pro /Con debate: Is procalcitonin useful for guiding antibiotic decision making in critically ill patients? Critical Care, 2008, 12: 211.
11.	Schuetz P, Christ-Crain M, M ü ller B. Procalcitonin and other biomarker to improve assessment and antibiotic stewardship infections-hope for hype? Swiss Med Wkly, 2009, 139: 318-326.
12.	Hedlund J, Hansson LO. Procalcitonin and C-reactive protein levels in community-acquired pneumonia: correlation with etiology and prognosis. Infection, 2000, 28 : 68 -73.
13.	Holm A, Pedersen S, Nexoe J, et al. Procalcitonin versus Creactive protein for predicting pneumonia in adults with lower respiratory tract infection in primary care. Br J Gen Pract, 2007,57: 555-560.
14.	Schleicher GK, Herbert V, Brink A, et al. Procalcitonin and Creactive protein levels in HIV-positive subjects with tuberculosis and pneumonia. Eur Respir J, 2005, 25: 688-692.
15.	Tejera A, Santolaria F, Diez ML, et al . Prognosis of community acquired pneumonia ( CAP) : value of triggering receptor expressed on myeloid cells-1 ( TREM-1 ) and other mediators of the inflammatory response. Cytokine, 2007, 38: 117-123.
16.	Chao WC, Wang CH, Chan MC, et al. Predictive value of serial measurements of sTREM-1 in the treatment response of patients with community-acquired pneumonia. J Formos Med Assoc, 2007 , 106 : 187-195.
17.	Huh JW, LimCM, Koh Y, et al. Diagnostic utility of the soluble triggering receptor expressed on myeloid cells-1 in bronchoalveolar lavage fluid from patients with bilateral lung infiltrates. Critical Care, 2008, 12: R6.
18.	Determann RM, Millo JL, Gibot S, et al. Serial changes in soluble triggering receptor expressed on myeloid cells in the lung during development of ventilator-associated pneumonia. Intensive Care Med, 2005, 31: 1495-1500.
19.	Christ-Crain M, Schuetz P, M ü ller B, et al. Biomarkers in the management of pneumonia. Expert Rev Respir Med, 2008, 2: 565-572.

1. Flanders SA, Stein J, Shochat G, et al. Performance of a bedside C-reactive protein test in the diagnosis of community-acquired pneumonia in adults with acute cough. Am J Med, 2004, 116: 529- 535.
2. Almirall J, Bol í bar I, Toran P, et al. Contribution of C-reactive protein to the diagnosis and assessment of severity of communityacquired pneumonia. Chest, 2004, 125: 1192-1195.
3. Smith RP, Lipworth BJ. C-reactive protein in simple communityacquired pneumonia. Chest, 1995, 107: 1028-1031.
4. Offidani M, Corvatta L, Malerba L, et al. Diagnostic value of Creactive protein in discriminating fungal from nonfungal pulmonary infiltrates in patients with hematologic malignancies. Support Care Cancer, 2006, 14: 874-877.
5. P ó voa P, Coelho L, Almeida E, et al. C-reactive protein as a marker of infection in critically ill patients. Clin Microbiol Infect,2005, 11: 101-108.
6. Chan YL, Tseng CP, Tsay PK, et al. Procalcitonin as a marker of bacterial infection in the emergency department: an observational study. Crit Care, 2004, 8: R12-R20.
7. Pelosi P, Barassi A, Severgnini P, et al. Prognostic role of clinical and laboratory criteria to identify early ventilator-associated pneumonia in brain injury. Chest, 2008, 134: 101-108.
8. Gendrel D, Raymon J, Moulin F, et al. Procalcitonin in community-acquired pneumonia: comparison with interleukin-6, Creactive protein, and interferon-alpha for diagnosis of bacterial vs.viral infections in children. Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother, 1999 , 39 :237.
9. Masi á M, Guti é rrez F, Shum C, et al. Usefulness of procalcitonin levels in community-acquired pneumonia according to the patients outcome research teampneumonia severity index. Chest, 2005, 128 :2223-2229.
10. Shehabi Y, Seppelt I. Pro /Con debate: Is procalcitonin useful for guiding antibiotic decision making in critically ill patients? Critical Care, 2008, 12: 211.
11. Schuetz P, Christ-Crain M, M ü ller B. Procalcitonin and other biomarker to improve assessment and antibiotic stewardship infections-hope for hype? Swiss Med Wkly, 2009, 139: 318-326.
12. Hedlund J, Hansson LO. Procalcitonin and C-reactive protein levels in community-acquired pneumonia: correlation with etiology and prognosis. Infection, 2000, 28 : 68 -73.
13. Holm A, Pedersen S, Nexoe J, et al. Procalcitonin versus Creactive protein for predicting pneumonia in adults with lower respiratory tract infection in primary care. Br J Gen Pract, 2007,57: 555-560.
14. Schleicher GK, Herbert V, Brink A, et al. Procalcitonin and Creactive protein levels in HIV-positive subjects with tuberculosis and pneumonia. Eur Respir J, 2005, 25: 688-692.
15. Tejera A, Santolaria F, Diez ML, et al . Prognosis of community acquired pneumonia ( CAP) : value of triggering receptor expressed on myeloid cells-1 ( TREM-1 ) and other mediators of the inflammatory response. Cytokine, 2007, 38: 117-123.
16. Chao WC, Wang CH, Chan MC, et al. Predictive value of serial measurements of sTREM-1 in the treatment response of patients with community-acquired pneumonia. J Formos Med Assoc, 2007 , 106 : 187-195.
17. Huh JW, LimCM, Koh Y, et al. Diagnostic utility of the soluble triggering receptor expressed on myeloid cells-1 in bronchoalveolar lavage fluid from patients with bilateral lung infiltrates. Critical Care, 2008, 12: R6.
18. Determann RM, Millo JL, Gibot S, et al. Serial changes in soluble triggering receptor expressed on myeloid cells in the lung during development of ventilator-associated pneumonia. Intensive Care Med, 2005, 31: 1495-1500.
19. Christ-Crain M, Schuetz P, M ü ller B, et al. Biomarkers in the management of pneumonia. Expert Rev Respir Med, 2008, 2: 565-572.

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