Pneumologie 2018; 72(05): 341-346
DOI: 10.1055/s-0043-118676
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Biomarker in der Diagnostik, Therapie und Prognose infektiöser Lungenerkrankungen

Biomarkers in Diagnosis, Treatment and Prognosis of Infectious Lung Diseases
M. Unnewehr
1   Medizinische Klinik Nord – Pneumologie, Infektiologie, Intensivmedizin; Klinikum Dortmund gGmbH, Dortmund
4   Universität Witten/Herdecke, Fakultät für Gesundheit, Department für Humanmedizin, Witten
,
M. Kolditz
2   Medizinische Klinik I – Pneumologe; Universitätsklinikum Carl Gustav Carus, Dresden
,
W. Windisch
3   Kliniken der Stadt Köln gGmbH – Lungenklinik Köln-Mehrheim, Köln
4   Universität Witten/Herdecke, Fakultät für Gesundheit, Department für Humanmedizin, Witten
,
B. Schaaf
1   Medizinische Klinik Nord – Pneumologie, Infektiologie, Intensivmedizin; Klinikum Dortmund gGmbH, Dortmund
› Author Affiliations
Further Information

Publication History

eingereicht 29 June 2017

akzeptiert nach Revision 22 August 2017

Publication Date:
18 October 2017 (online)

Zusammenfassung

Biomarker spielen eine bedeutende Rolle im Management infektiöser Lungenerkrankungen, wenngleich bisher nur ansatzweise gezeigt werden konnte, dass biomarkergestützte Therapien klinischen Strategien überlegen sind.

Etablierte Indikationen für die Verwendung von Biomarkern sind die Steuerung der antibiotischen Therapiedauer der ambulant erworbenen Pneumonie (CAP) über PCT, die Entscheidung gegen Antibiotika im ambulanten Bereich über CRP oder PCT sowie die Verlaufsevaluation der CAP aus der Kinetik von CRP oder PCT.

Für die Prognosebeurteilung der CAP stehen die Standard-Biomarker der akuten Organdysfunktion wie z. B. Leukozyten- und Thrombozytenzahl, Kreatinin/Harnstoff sowie Laktat in Zusammenschau mit der Klinik im Vordergrund.

Das MR-pro-ADM könnte die Diagnostik in Zukunft weiter bereichern. Ein völlig neuartiges und zukünftig vielsprechendes Konzept ist die genetische Transkriptomanalyse.

Abstract

Biomarkers play an important role in the management of infectious pulmonary diseases, even though there is only limited evidence that biomarker-guided therapies are superior to clinical strategies.

Well-established indications for the use of biomarkers are the guidance of the duration of antibiotic therapy in community-acquired pneumonia (CAP) by PCT, the decision against the use of antibiotics by CRP or PCT in ambulatory settings, and the evaluation of CAP treatment by CRP or PCT kinetics.

In the prognostic assessment of CAP, the standard biomarkers of acute organ dysfunction should be given priority, e. g. leukocyte and platelet counts, creatinine/urea and lactate, in combination with clinical signs and symptoms.

MR-pro-ADM could enrich diagnostics in the future. Genetic transcriptome analysis is a completely new and promising concept.

 
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