Objective To study the clinical value of serum procalcitonin (PCT) concentration in elderly patients with heart failure during the treatment of anti-infective therapy. Methods A total of 200 elderly patients with heart failure who were treated in ICU from February,2015 to March,2016 were randomly divided into two groups:experimental group (PCT) and control group (conventional treatment group) people. The two groups of patients were routine treatment,the control group of patients by physician analysis to determine the best time to use antimicrobial therapy,the experimental group by a certain number of elderly patients with heart failure after admission in the first 1,3,7,14 days. Analysis of changes in PCT concentration to determine whether anti-infective treatment of patients with the use of antimicrobial drugs. Observe the two groups of patients with antibiotic treatment,hospital stay, hospital costs,double infection rate and other indicators. Results There were no significant differences in age,sex,course of disease, LVEF and leukocyte between the two groups. Among the pathogens isolated from the two groups,klebsiella pneumoniae,acinetobacter baumannii,the number of pseudomonas aeruginosa was the highest,the average hospitalization cost of the experimental group was lower than that of the control group. The course of antimicrobial treatment was significantly lower in the experimental group than that in the control group. The dosage and cost of the antibiotics in the experimental group were lower than the control group ,The infection rate was 7% in the control group and 3% in the control group. The difference was statistically significant (P < 0.05). Conclusion PCT dynamic changes in the elderly patients with severe heart failure to guide the use of antimicrobial agents have a certain significance,according to the level of PCT changes to determine whether the use of antibiotics,whether to disable antibiotics,and evaluate the efficacy of antibiotics. In ICU elderly patients with heart failure in the treatment of anti-infection treatment of PCT concentration changes in the use of drugs,can reduce the use of antimicrobial drugs and hospital stay and drug resistance.%目的 研究老年心力衰竭患者在治疗时的血清降钙素原(PCT)水平浓度变化对抗感染治疗的临床价值.方法选取2015年2月~2016年3月在无极县医院和石家庄市第五医院接受治疗的老年心力衰竭患者200例,随机分为试验组(PCT指导治疗)和对照组(常规治疗),每组各100例.两组患者均进行常规治疗,对照组患者经医师分析确定是否使用抗菌药物,试验组通过对老年心衰患者在入院治疗后第1、3、7、14天时的PCT浓度变化分析,确定对患者的抗感染治疗是否需要在适当时机使用抗菌类药物.观察两组患者的抗菌药物治疗过程、住院时间、住院费用、二重感染率等指标.结果两组患者入组时在年龄、性别、病程、左心室射血分数(LVEF)值、白细胞等临床特征上差异无统计学意义(P<0.05).在两组患者分离出的病原菌中,肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌数量最多,试验组患者的平均住院总费用低于对照组,试验组患者进行的抗菌药物疗程明显低于对照组,试验组抗菌药物的用量、费用均低于对照组,对照组患者的二重感染率为7%、试验组为3%,差异均具有统计学意义(P<0.05).结论PCT动态变化在指导重症老年心衰患者使用抗菌药物中具有一定的意义,可将PCT水平的动态变化作为决定是否使用抗生素、是否停用抗生素、以及评价抗菌药物疗效的辅助指标,可减少抗菌药物的使用量,减少住院时间,降低患者耐药率.
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