To date no biomarkers can aid diagnosing sepsis with adequate accuracy. We set out to assess the ability of Tumor necrosis factor receptor (TNFR) 1 and 2, Neutrophil gelatinase-associated lipocalin (NGAL) and Heparin binding protein (HBP) to discriminate sepsis from non-infected critically ill patients in a large ICU cohort, and to evaluate their value to predict mortality at 30 days. Adult patients admitted to the ICU with an arterial catheter were included. Clinical data and blood samples were prospectively recorded daily. Diagnoses were set retrospectively. Descriptive statistics and logistic regression models were used. NGAL, TNFR1 and TNFR2 were higher in sepsis patients compared to other diagnoses, as well as in non-survivors compared to survivors. In addition, these biomarkers increased with increasing stages of acute kidney injury. TNFR1 and TNFR2 performed similarly to NGAL and CRP in identifying sepsis patients, but they performed better than CRP in predicting 30-day mortality in this ICU cohort. Thus, TNFR1 and TNFR2 may be particularly useful in identifying high risk sepsis patients and facilitate relevant health care actions in this group of sepsis patients.

迄今为止，没有任何生物标志物可以帮助准确诊断败血症。我们着手评估肿瘤坏死因子受体 (TNFR) 1 和 2、中性粒细胞明胶酶相关脂质运载蛋白 (NGAL) 和肝素结合蛋白 (HBP) 在大型 ICU 队列中区分败血症与未感染危重患者的能力，并评估它们预测 30 天死亡率的价值。包括使用动脉导管入住 ICU 的成年患者。每天前瞻性地记录临床数据和血液样本。诊断是回顾性设定的。使用了描述性统计和逻辑回归模型。与其他诊断相比，脓毒症患者中的 NGAL、TNFR1 和 TNFR2 更高，与幸存者相比，非幸存者中的 NGAL、TNFR1 和 TNFR2 更高。此外，这些生物标志物随着急性肾损伤阶段的增加而增加。TNFR1 和 TNFR2 在识别脓毒症患者方面的表现与 NGAL 和 CRP 相似，但在预测该 ICU 队列中的 30 天死亡率方面，它们的表现优于 CRP。因此，TNFR1 和 TNFR2 可能特别有助于识别高危败血症患者并促进这组败血症患者的相关医疗保健行动。