降钙素原监测在老年非重症社区获得性肺炎抗生素治疗中的指导作用

摘要

Objective To evaluate the value of serum procaleitonin(PCT) on antibiotic treatment of elderly non severe community-acquired pneumonia(CAP). Methods 55 patients with non severe CAP in outpatient were randomly assigned into two groups:PCT group (n=28) and control group (n=27). Serum PCT levels of al patients were measured before study admission. On the base of similarly normal treatment, the control group received antibiotics according to the at ending physicians and the PCT group were treated with antibiotics according to serum PCT levels. Antibiotic treatment was applied with PCT≥0.25μg/L and was discouraged with PCT<0.25μg/L. Subsequent visit also according to the standard to decide whether to continue to use antibiotics. Compare clinical indicators, the cost of treatment, the antibiotic use time and the distribution of the difference after two weeks treatment. Results The level of PCT in the PCT group was lower than treatment before;rates of antibiotics use was lower than that of the control group. There was no signiifcant difference in the prognosis of patients. Conclusion PCT could be used in antibiotic treatment of elderly non severe CAP in outpatient, which may reduce antibiotic use, shorten antibiotic duration and lower costs of antibiotic.%目的：探讨血清降钙素原(procalcitonin，PCT)对接受门诊治疗的老年非重症社区获得性肺炎（community-acquired pneumonia）患者的抗生素使用指导意义。方法选择接受门诊治疗的老年非重症CAP患者55例，分为PCT监测组28例，对照组27例。入组患者均监测血清PCT水平，对照组根据我国CAP治疗指南选择抗生素治疗方案；PCT组在血清PCT≥0.25μg/L时使用抗生素治疗，PCT＜0.25μg/L时不予抗生素治疗，复诊时亦按照此标准决定是否继续使用抗生素。比较上述两组治疗两周后临床指标、治疗费用、抗生素使用时间及分布的差异。结果两组治疗后各临床指标的恢复无明显差异（P＞0.05），PCT组抗生素使用时间低于对照组（P＜0.05），抗生素使用分布上明显优于对照组（P＜0.05），同时治疗费用也低于对照组（P＜0.05）。结论老年非重症CAP患者可以依据PCT水平指导抗生素应用，能够缩短抗生素疗程，降低治疗费用。