降钙素原与创伤的研究进展_West China Medical Journal

Authors：

刘少锋 , 杨健 ,  刘敏

Corresponding author：

刘敏, Email: fendoushaofeng@126.com.cn

Keywords：

降钙素原; 创伤; 感染; 脓毒症

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

创伤是导致炎症反应的重要因素之一，炎症反应和感染是创伤后常见的病理生理过程，而由此所致的脓毒症或脓毒症休克是创伤后患者死亡的重要原因。感染的早期诊治与预后密切相关。临床上许多感染监测指标如体温、C反应蛋白、白细胞计数、白细胞介素6和肿瘤坏死因子α等诊断感染缺乏特异性，而血培养阳性率低、耗时长且较难区分细菌定植或感染，在临床应用受到很大的限制，使得临床医师对于创伤后感染的诊断更加困难。近年来降钙素原（PCT）是被认为是诊断细菌感染有效的生物学指标。诸多研究认为PCT可以作为诊断创伤后并发症的工具，其水平的高低与创伤的严重程度及预后相关。现就PCT与创伤的研究进展进行综述。

Citation： 刘少锋,杨健,刘敏. 降钙素原与创伤的研究进展. West China Medical Journal, 2012, 27(5): 789-793. doi: Copy

1.	Moya F, Nieto A, R-Candela JL. Calcitonin biosynthesis: evidence for a precursor[J]. Eur J Biochem, 1975, 55(2): 407-413.
2.	Assicot M, Bohuon C, Gendrel D, et al. High serum procalcitonin concentrations in patients with sepsis and infection[J]. Lancet, 1993, 341(8844): 515-518.
3.	Nishikura T. Procalcitonin (PCT) production in a thyroidectomized patient[J]. Intensive Care Med, 1999, 25(9):1031.
4.	Snider RH Jr, Nylen ES, Becker KL. Procalcitonin and its component peptides in systemic inflammation: immunochemical characterization[J]. J Investig Med, 1997, 45(9): 552-560.
5.	Becker KL, Nylén ES, White JC, et al. Clinical review 167: Procalcitonin and the calcitonin gene family of peptides in inflammation, infection, and sepsis: a journey from calcitonin back to its precursors[J]. Clin Endocrinol Metab, 2004, 89(4): 1512-1525.
6.	Morgenthaler NG, Struck J, Chancerelle Y, et al. Production of procalcitonin (PCT) in non-thyroidal tissue after LPS injection[J]. Horm Metab Res, 2003, 35(5): 290-295.
7.	Müller B, White JC, Nylén ES, et al. Ubiquitous expression of the calcitonin-i gene in multiple tissues in response to sepsis[J]. Clin Endocrinol Metab, 2001, 86(1): 396-404.
8.	Linscheid P, Seboek D, Nylen ES, et al. In vitro and in vivo calcitonin I gene expression in parenchymal cells: a novel product of human adipose tissue[J]. Endocrinology, 2003, 144(12): 5578-5584.
9.	Oberhoffer M, Vogelsang H, Jäger L, et al. Katacalcin and calcitonin immunoreactivity in different types of leukocytes indicate intracellular procalcitonin content[J]. J Crit Care, 1999, 14(1): 29-33.
10.	Monneret G, Laroche B, Bienven J. Procalcitonin is not produced by circulating blood cells[J]. Infection, 1999, 27(1): 34-35.
11.	Maruna P, Nedelnikova K, Gurlich R. Physiology and genetics of procalcitonin[J]. Physiol Res, 2000, 49(Suppl 1): S57-S61.
12.	Preas HL 2nd, Nylen ES, Snider RH, et al. Effects of anti-inflammatory agents on serum levels of calcitonin precursors during human experimental endotoxemia[J]. Infect Dis, 2001, 184(3): 373-376.
13.	Hoffmann G, Czechowski M, Schloesser M, et al. Procalcitonin amplifies inducible nitric oxide synthase gene expression and nitric oxide production in vascular smooth muscle cells[J]. Crit Care Med, 2002, 30(9): 2091-2095.
14.	Wei JX, Verity A, Garle M, et al. Examination of the effect of procalcitonin on human leucocytes and the porcine isolated coronary artery[J]. Br J Anaesth, 2008, 100(5): 612-621.
15.	Pincíková T, Bucová M, Slobodníková L. Influrence of recombinant human procalcitonin on phagocytic and candidacidal ability of polymorphonuclear leukocytes and on killing mechanisms of serum and blood aganist bacteria Staphylococcus aureus and Escherichia coli[J]. Vnitr Lek, 2005, 51(12): 1365-1370.
16.	Meisner M, Tschaikowsky K, Schnabel S, et al. Procalcitonin--influence of temperature, storage, anticoagulation and arterial or venous asservation of blood samples on procalcitonin concentrations[J]. Eur J Clin Chem Clin Biochem, 1997, 35(8): 597-601.
17.	Meisner M, Schmidt J, Hüttner H, et al. The natural elimination rate of procalcitonin in patients with normal and impaired renal function[J]. Intensive Care Med, 2000, 26(Suppl 2): S212-S216.
18.	Mimoz O, Benoist JF, Edouard AR, et al. Procalcitonin and C-reactive protein during the early posttraumatic systemic inflammatory response syndrome[J]. Intensive Care Med, 1998, 24(2): 185-188.
19.	Benoist JF, Mimoz O, Assicot M, et al. Serum procalcitonin, but not c-reactive protein, identifies sepsis in trauma patients[J]. Clin Chem, 1998, 44(8 Pt 1): 1778-1779.
20.	Nie H, Jiang D, Ou Y, et al. Procalcitonin as an early predictor of postoperative infectious complications in patients with acute traumatic spinal cord injury[J]. Spinal Cord, 2011, 49(6): 715-720.
21.	Hahm G, Glaser JJ, Elster EA. Biomarkers to predict wound healing: the future of complex war wound management[J]. Plast Reconstr Surg, 2011, 127(Suppl 1): 21S-26S.
22.	Pusch F, Wildling E, Freitag H, et al. Procalcitonin as a diagnostic marker in patients with aspiration after closed head injury[J]. Wien Klin Wochenschr, 2001, 113(17-18): 676-680.
23.	Pelosi P, Barassi A, Severgnini P, et al. Prognostic role of clinical and laboratory criteria to identify early ventilator-associated pneumonia in brain injury[J]. Chest, 2008, 134(1): 101-108.
24.	Maier M, Wutzler S, Lehnert M, et al. Serum procalcitonin levels in patients with multiple injuries including visceral trauma[J]. J Trauma, 2009, 66(1): 243-249.
25.	Haasper C, Kalmbach M, Dikos GD, et al. Prognostic value of procalcitonin (PCT) and/or interleukin-6 (IL-6) plasma levels after multiple trauma for the development of multi organ dysfunction syndrome (MODS) or sepsis[J]. Technol Health Care, 2010, 18(2): 89-100.
26.	Balci C, Sivaci R, Akbulut G, et al. Procalcitonin levels as an early marker in patients with multiple trauma under intensive care[J]. J Int Med Res, 2009, 37(6): 1709-1717.
27.	Castelli GP, Pognani C, Cita M, et al. Procalcitonin as a prognostic and diagnostic tool for septic complications after major trauma[J]. Crit Care Med, 2009, 37(6): 1845-1849.
28.	Billeter A, Turina M, Seifert B, et al. Early serum procalcitonin, interleukin-6, and 24-hour lactate clearance: useful indicators of septic infections in severely traumatized patients[J]. World J Surg, 2009, 33(3): 558-566.
29.	Uzzan B, Cohen R, Nicolas P. Procalcitonin as a diagnostic test for sepsis in critically ill adults and after surgery or trauma:a systematic review and meta-analysis[J]. Crit Care Med, 2006, 34(7): 1996-2003.
30.	Oconnor E, Venkatesh B, Mashongonyika C, et al. Serum procalcitonin and C-reactive protein as markers of sepsis and outcome in patients with neurotrauma and subarachnoid haemorrhage[J]. Anaesth Intensive Care, 2004, 32(4): 465-470.
31.	Wanner GA, Keel M, Steckholzer U, et al. Relationship between procalcitonin plasma levels and severity of injury, sepsis, organ failure, and mortality in injured patients[J]. Crit Care Med, 2000, 28(4): 950-957.
32.	Claeys R, Vinken S, Spapen H, et al. Plasma procalcitonin and C-reactive protein in acute septic shock: clinical and biological correlates[J]. Crit Care Med, 2002, 30(4): 757-762.
33.	王赤, 任天成, 戚晓庄, 等. 血清PCT变化在严重创伤致MODS早期诊断中的临床意义[J].山东医药, 2010, 50(5): 57-58.
34.	Svoboda P, Kantorová I, Scheer P, et al. Can procalcitonin help us in timing of re-intervention in septic patients after multiple trauma or major surgery?[J]. Hepatogastroenterology, 2007, 54(74): 359-363.
35.	Müller B, Schuetz P, Trampuz A. Circulating biomarkers as surrogates for bloodstream infections[J]. Int J Antimicrob Agents, 2007, 30 Suppl 1(Suppl 1): S16-S23.
36.	Bouadma L, Luyt CE, Tubach F, et al. Use of procalcitonin to reduce patients’ exposure to antibiotics in intensive care units (PRORATA trial): a multicentre randomised controlled trial[J]. Lancet, 2010, 375(9713): 463-474.
37.	向大开, 夏庆. PCT在急性胰腺炎中的研究进展[J]. 华西医学, 2008, 23(2): 412-413.
38.	Nylén ES, Whang KL, Steinwald PM, et al. Procalcitonin increases mortality and procalcitonin recognizing antiserum improves mortality in an experimental model of sepsis[J]. Crit Care Med, 1998, 26(6): 1001–1006.
39.	Wagner KE, Martinez JM, Vath SD, et al. Early immunoneutralization of calcitonin precursors attenuates the adverse physiologic response to sepsis in pigs[J]. Crit Care Med, 2002, 30(10): 2313-2321.

1. 　Moya F, Nieto A, R-Candela JL. Calcitonin biosynthesis: evidence for a precursor[J]. Eur J Biochem, 1975, 55(2): 407-413.
2. 　Assicot M, Bohuon C, Gendrel D, et al. High serum procalcitonin concentrations in patients with sepsis and infection[J]. Lancet, 1993, 341(8844): 515-518.
3. 　Nishikura T. Procalcitonin (PCT) production in a thyroidectomized patient[J]. Intensive Care Med, 1999, 25(9):1031.
4. 　Snider RH Jr, Nylen ES, Becker KL. Procalcitonin and its component peptides in systemic inflammation: immunochemical characterization[J]. J Investig Med, 1997, 45(9): 552-560.
5. 　Becker KL, Nylén ES, White JC, et al. Clinical review 167: Procalcitonin and the calcitonin gene family of peptides in inflammation, infection, and sepsis: a journey from calcitonin back to its precursors[J]. Clin Endocrinol Metab, 2004, 89(4): 1512-1525.
6. 　Morgenthaler NG, Struck J, Chancerelle Y, et al. Production of procalcitonin (PCT) in non-thyroidal tissue after LPS injection[J]. Horm Metab Res, 2003, 35(5): 290-295.
7. 　Müller B, White JC, Nylén ES, et al. Ubiquitous expression of the calcitonin-i gene in multiple tissues in response to sepsis[J]. Clin Endocrinol Metab, 2001, 86(1): 396-404.
8. 　Linscheid P, Seboek D, Nylen ES, et al. In vitro and in vivo calcitonin I gene expression in parenchymal cells: a novel product of human adipose tissue[J]. Endocrinology, 2003, 144(12): 5578-5584.
9. 　Oberhoffer M, Vogelsang H, Jäger L, et al. Katacalcin and calcitonin immunoreactivity in different types of leukocytes indicate intracellular procalcitonin content[J]. J Crit Care, 1999, 14(1): 29-33.
10. 　Monneret G, Laroche B, Bienven J. Procalcitonin is not produced by circulating blood cells[J]. Infection, 1999, 27(1): 34-35.
11. 　Maruna P, Nedelnikova K, Gurlich R. Physiology and genetics of procalcitonin[J]. Physiol Res, 2000, 49(Suppl 1): S57-S61.
12. 　Preas HL 2nd, Nylen ES, Snider RH, et al. Effects of anti-inflammatory agents on serum levels of calcitonin precursors during human experimental endotoxemia[J]. Infect Dis, 2001, 184(3): 373-376.
13. 　Hoffmann G, Czechowski M, Schloesser M, et al. Procalcitonin amplifies inducible nitric oxide synthase gene expression and nitric oxide production in vascular smooth muscle cells[J]. Crit Care Med, 2002, 30(9): 2091-2095.
14. 　Wei JX, Verity A, Garle M, et al. Examination of the effect of procalcitonin on human leucocytes and the porcine isolated coronary artery[J]. Br J Anaesth, 2008, 100(5): 612-621.
15. 　Pincíková T, Bucová M, Slobodníková L. Influrence of recombinant human procalcitonin on phagocytic and candidacidal ability of polymorphonuclear leukocytes and on killing mechanisms of serum and blood aganist bacteria Staphylococcus aureus and Escherichia coli[J]. Vnitr Lek, 2005, 51(12): 1365-1370.
16. 　Meisner M, Tschaikowsky K, Schnabel S, et al. Procalcitonin--influence of temperature, storage, anticoagulation and arterial or venous asservation of blood samples on procalcitonin concentrations[J]. Eur J Clin Chem Clin Biochem, 1997, 35(8): 597-601.
17. 　Meisner M, Schmidt J, Hüttner H, et al. The natural elimination rate of procalcitonin in patients with normal and impaired renal function[J]. Intensive Care Med, 2000, 26(Suppl 2): S212-S216.
18. 　Mimoz O, Benoist JF, Edouard AR, et al. Procalcitonin and C-reactive protein during the early posttraumatic systemic inflammatory response syndrome[J]. Intensive Care Med, 1998, 24(2): 185-188.
19. 　Benoist JF, Mimoz O, Assicot M, et al. Serum procalcitonin, but not c-reactive protein, identifies sepsis in trauma patients[J]. Clin Chem, 1998, 44(8 Pt 1): 1778-1779.
20. 　Nie H, Jiang D, Ou Y, et al. Procalcitonin as an early predictor of postoperative infectious complications in patients with acute traumatic spinal cord injury[J]. Spinal Cord, 2011, 49(6): 715-720.
21. 　Hahm G, Glaser JJ, Elster EA. Biomarkers to predict wound healing: the future of complex war wound management[J]. Plast Reconstr Surg, 2011, 127(Suppl 1): 21S-26S.
22. 　Pusch F, Wildling E, Freitag H, et al. Procalcitonin as a diagnostic marker in patients with aspiration after closed head injury[J]. Wien Klin Wochenschr, 2001, 113(17-18): 676-680.
23. 　Pelosi P, Barassi A, Severgnini P, et al. Prognostic role of clinical and laboratory criteria to identify early ventilator-associated pneumonia in brain injury[J]. Chest, 2008, 134(1): 101-108.
24. 　Maier M, Wutzler S, Lehnert M, et al. Serum procalcitonin levels in patients with multiple injuries including visceral trauma[J]. J Trauma, 2009, 66(1): 243-249.
25. 　Haasper C, Kalmbach M, Dikos GD, et al. Prognostic value of procalcitonin (PCT) and/or interleukin-6 (IL-6) plasma levels after multiple trauma for the development of multi organ dysfunction syndrome (MODS) or sepsis[J]. Technol Health Care, 2010, 18(2): 89-100.
26. 　Balci C, Sivaci R, Akbulut G, et al. Procalcitonin levels as an early marker in patients with multiple trauma under intensive care[J]. J Int Med Res, 2009, 37(6): 1709-1717.
27. 　Castelli GP, Pognani C, Cita M, et al. Procalcitonin as a prognostic and diagnostic tool for septic complications after major trauma[J]. Crit Care Med, 2009, 37(6): 1845-1849.
28. 　Billeter A, Turina M, Seifert B, et al. Early serum procalcitonin, interleukin-6, and 24-hour lactate clearance: useful indicators of septic infections in severely traumatized patients[J]. World J Surg, 2009, 33(3): 558-566.
29. 　Uzzan B, Cohen R, Nicolas P. Procalcitonin as a diagnostic test for sepsis in critically ill adults and after surgery or trauma:a systematic review and meta-analysis[J]. Crit Care Med, 2006, 34(7): 1996-2003.
30. 　Oconnor E, Venkatesh B, Mashongonyika C, et al. Serum procalcitonin and C-reactive protein as markers of sepsis and outcome in patients with neurotrauma and subarachnoid haemorrhage[J]. Anaesth Intensive Care, 2004, 32(4): 465-470.
31. 　Wanner GA, Keel M, Steckholzer U, et al. Relationship between procalcitonin plasma levels and severity of injury, sepsis, organ failure, and mortality in injured patients[J]. Crit Care Med, 2000, 28(4): 950-957.
32. 　Claeys R, Vinken S, Spapen H, et al. Plasma procalcitonin and C-reactive protein in acute septic shock: clinical and biological correlates[J]. Crit Care Med, 2002, 30(4): 757-762.
33. 　王赤, 任天成, 戚晓庄, 等. 血清PCT变化在严重创伤致MODS早期诊断中的临床意义[J].山东医药, 2010, 50(5): 57-58.
34. 　Svoboda P, Kantorová I, Scheer P, et al. Can procalcitonin help us in timing of re-intervention in septic patients after multiple trauma or major surgery?[J]. Hepatogastroenterology, 2007, 54(74): 359-363.
35. 　Müller B, Schuetz P, Trampuz A. Circulating biomarkers as surrogates for bloodstream infections[J]. Int J Antimicrob Agents, 2007, 30 Suppl 1(Suppl 1): S16-S23.
36. 　Bouadma L, Luyt CE, Tubach F, et al. Use of procalcitonin to reduce patients’ exposure to antibiotics in intensive care units (PRORATA trial): a multicentre randomised controlled trial[J]. Lancet, 2010, 375(9713): 463-474.
37. 　向大开, 夏庆. PCT在急性胰腺炎中的研究进展[J]. 华西医学, 2008, 23(2): 412-413.
38. 　Nylén ES, Whang KL, Steinwald PM, et al. Procalcitonin increases mortality and procalcitonin recognizing antiserum improves mortality in an experimental model of sepsis[J]. Crit Care Med, 1998, 26(6): 1001–1006.
39. 　Wagner KE, Martinez JM, Vath SD, et al. Early immunoneutralization of calcitonin precursors attenuates the adverse physiologic response to sepsis in pigs[J]. Crit Care Med, 2002, 30(10): 2313-2321.

West China Medical Journal

降钙素原与创伤的研究进展

Abstract Full text Figures/Tables Video References Cited by

Format

Content