血清降钙素原对慢性阻塞性肺疾病急性加重期抗生素使用的指导价值

摘要

目的：探讨血清降钙素原(PCT)在慢性阻塞性肺疾病急性加重期(AECOPD)优化抗生素应用中的价值。方法80例AECOPD患者随机分为观察组和对照组，各40例，对照组根据经验使用抗生素，观察组根据血清PCT水平指导抗生素应用。当血清PCT≥0.25 ng/ml时，进行抗生素治疗，当PCT<0.25 ng/ml时，则停止使用抗生素治疗。并观察两组患者抗生素的使用疗程，抗生素所用费用及住院时间。结果观察组患者抗菌药物疗程、抗生素使用费用、住院费用及二重感染率明显低于对照组，差异有统计学意义(P<0.05)。两组的住院时间及临床有效率比较差异无统计学意义(P>0.05)。结论 AECOPD患者根据PCT水平使用抗生素，能较明显缩短抗生素的使用疗程，减少医疗费用，有效防止抗生素过度使用。%Objective To explore the value of procalcitonin (PCT) for optimized antibiotics application in acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods A total of 80 AECOPD patients were randomly divided into observation group and control group, with 40 cases in each group. The control group received antibiotics by application experience, while the observation group was given antibiotics under guidance of serum PCT level. When serum PCT≥0.25 ng/ml, antibiotics was given;When PCT<0.25 ng/ml, application of antibiotics was stopped. Antibiotics application course, antibiotics application costs and hospital stays of the two groups were observed. Results The observation group had obviously shorter antibiotics application course, and lower antibiotics application costs and double infection rate than the control group, and the difference had statistical significance (P<0.05). There were no statistically significant differences of hospital stays and clinical effective rates between the two groups (P>0.05). Conclusion The antibiotics use under guidance by PCT level for AECOPD patients can remarkably reduce antibiotics application course and medical costs, and it can also effectively prevent overuse of antibiotics.